Clinical Characteristics and Surgical Outcomes of Patients with Aneurysmal Subarachnoid Hemorrhage and Acute Subdural Hematoma Undergoing Decompressive Craniectomy

Acute subdural hematoma is a rare presentation of ruptured aneurysms. The rarity of the disease makes it difficult to establish reliable clinical guidelines. Many patients present comatose and differential diagnosis is complicated due to aneurysm rupture results in or mimics traumatic brain injury. Fast decision-making is required to treat this life-threatening condition. Determining initial diagnostic studies, as well as making treatment decisions, can be complicated by rapid deterioration of the patient, and the mixture of symptoms due to the subarachnoid hemorrhage or mass effect of the hematoma. This paper reviews initial clinical and radiological findings, diagnostic approaches, treatment modalities, and outcome of patients presenting with aneurysmal subarachnoid hemorrhage complicated by acute subdural hematoma. Clinical strategies used by several authors over the past 20 years are discussed and summarized in a proposed treatment flowchart.

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Comparison of Craniotomy and Decompressive Craniectomy in Severely Head-Injured Patients With Acute Subdural Hematoma

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2012.05.062 ◽

2012 ◽

Vol 2012 ◽

pp. 316-318

Author(s):

B.T. Ragel ◽

A.M. Raslan

Keyword(s):

Decompressive Craniectomy ◽

Subdural Hematoma ◽

Acute Subdural Hematoma ◽

Head Injured ◽

Injured Patients

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Size does matter: The role of decompressive craniectomy extent for outcome after aneurysmal subarachnoid hemorrhage

European Journal of Neurology ◽

10.1111/ene.14835 ◽

2021 ◽

Cited By ~ 1

Author(s):

Ramazan Jabbarli ◽

Shi‐Qing He ◽

Marvin Darkwah Oppong ◽

Annika Herten ◽

Mehdi Chihi ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Decompressive Craniectomy ◽

Aneurysmal Subarachnoid Hemorrhage

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Clinical application of magnetic resonance in acute traumatic brain injury

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000100013 ◽

2008 ◽

Vol 66 (1) ◽

pp. 53-58 ◽

Cited By ~ 12

Author(s):

Dionei F. Morais ◽

Antonio R. Spotti ◽

Waldir A. Tognola ◽

Felipe F.P. Gaia ◽

Almir F. Andrade

Keyword(s):

Traumatic Brain Injury ◽

Subarachnoid Hemorrhage ◽

Brain Injury ◽

Magnetic Resonance ◽

Subdural Hematoma ◽

Diffuse Axonal Injury ◽

Correlation Method ◽

Acute Subdural Hematoma ◽

Acute Traumatic Brain Injury ◽

Magnetic Resonance Imaging Mri

PURPOSE: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. METHOD: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. RESULTS: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. CONCLUSION: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.

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