Intraparenchymal Hemorrhage After Evacuation of Chronic Subdural Hematoma: A Case Series and Literature Review

2021 ◽  
Author(s):  
Evan M. Krueger ◽  
Aaron J. Gustin ◽  
Paul J. Gustin ◽  
Zachary Jaffa ◽  
Hamad Farhat
Keyword(s):  
Literature Review ◽  
Subdural Hematoma ◽  
Case Series ◽  
Chronic Subdural Hematoma ◽  
Intraparenchymal Hemorrhage

scholarly journals Clinical manifestations of chronic subdural hematoma in the elderly: Literature Review

2021 ◽  
Author(s):  
Gabriela Ferreira Kalkmann ◽  
Carlos Umberto Pereira ◽  
Francisco de Assis Pereira ◽  
Débora Moura da Paixão Oliveira ◽  
Nicollas Nunes Rabelo
Keyword(s):  
Early Diagnosis ◽  
Literature Review ◽  
Subdural Hematoma ◽  
Elderly Population ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Chronic Subdural Hematoma ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Study Results

Introduction: The clinical manifestations of chronic subdural hematoma (CSDH) are often confused with other medical entities in the elderly, making their early diagnosis difficult or difficult. Early diagnosis is important, since its prognosis is directly associated with the preoperative neurological state, thus resulting in a worse vital and functional prognosis. Objectives: Report through a literature review the clinical manifestations of CSDH in the elderly population. Methods: Literature review, with the search terms: “Signs and Symptoms”, “Chronic Subdural Hematoma”, Aged, Diagnosis and Prognosis. In which PubMed, Lilacs, Scielo, Cochrane and TripDataBase data platforms were used. The inclusion criteria were: original studies published in any language. Articles in which full reading was prevented were excluded. With the application of the inclusion and exclusion criteria, 110 articles were included in the study. Results: Clinical presentation depends on the location, volume of the hematoma, rapid growth, the location of the CSDH, whether unilateral or bilateral, and the clinical conditions of the patient. Because the forms of clinical presentation of CSDH are variable, it is necessary that health professionals linked to the elderly (geriatrician, psychiatrist, general practitioner) have knowledge of this clinical entity. Conclusions: The recognition of classic forms as well as the identification of risk factors in the elderly favors the timely diagnosis and treatment of CSDH in the elderly population.

Transradial middle meningeal artery embolization for chronic subdural hematoma using Onyx: case series

2020 ◽  
pp. neurintsurg-2020-016185
Author(s):  
Gary B Rajah ◽  
Muhammad Waqas ◽  
Rimal H Dossani ◽  
Kunal Vakharia ◽  
Andrew D Gong ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Conscious Sedation ◽  
Case Series ◽  
Chronic Subdural Hematoma ◽  
Antiplatelet Agents ◽  
Middle Meningeal Artery ◽  
Complication Rates ◽  
Femoral Access ◽  
Guide Catheter ◽  
Meningeal Artery

BackgroundMiddle meningeal artery (MMA) embolization is an emerging therapy for the resolution of subacute or chronic subdural hematoma (CSDH). CSDH patients are often elderly and have several comorbidities. We evaluated our experience with transradial access (TRA) for MMA embolization using predominantly Onyx under conscious sedation.MethodsData for consecutive patients who underwent transradial MMA embolization for CSDH during a 2-year period (2018–2019) were analyzed from a single-center, prospectively-maintained database. Patient demographics, comorbidities, ambulatory times, subdural hematoma resorption status, and guide catheter type were recorded. Conversion to femoral access and complication rates were also recorded. Univariate and multivariate analyses were performed.ResultsForty-six patients (mean age, 71.7±14.4 years) were included in this study. Mean CSDH size was 14±5.5 mm. Most (91.3%) TRA embolizations were performed with 6-French 0.071-inch Benchmark guide catheters (Penumbra). MMA embolization was successful in 44 patients (95.7%) (including two cases of TRA conversion). Twenty-one (48%) patients had a severe Charlson Comorbidity Index (>5). Symptomatic improvement was noted in 39 of 44 patients (88.6%). Mean length of stay was 4±3 days. Patients were ambulated immediately postprocedure. At mean follow-up (8±4 weeks), 86.4% of patients had complete or partial CSDH resolution. Persistent use of antiplatelet agents after the procedure was associated with failed or minimal CSDH resorption (5 of 6, 83.3% vs 9 of 38 23.7% with complete or near-complete resolution; P=0.009).ConclusionTransradial Onyx MMA embolization under conscious sedation is safe and effective for CSDH treatment. TRA may be especially useful in elderly patients with numerous comorbidities.

scholarly journals Twist drill craniostomy for traumatic acute subdural hematoma in the elderly: case series and literature review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Pei-kun Huang ◽  
Yong-zhong Sun ◽  
Xue-ling Xie ◽  
De-zhi Kang ◽  
Shu-fa Zheng ◽  
...  
Keyword(s):  
Literature Review ◽  
Subdural Hematoma ◽  
Case Series ◽  
The Elderly ◽  
Acute Subdural Hematoma ◽  
Twist Drill

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Series of 60 Cases

Neurosurgery ◽  
2018 ◽  
Vol 85 (6) ◽  
pp. 801-807 ◽  
Author(s):  
Thomas W Link ◽  
Srikanth Boddu ◽  
Stephanie M Paine ◽  
Hooman Kamel ◽  
Jared Knopman
Keyword(s):  
Subdural Hematoma ◽  
Large Scale ◽  
Case Series ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Recurrence Rates ◽  
Surgical Evacuation ◽  
Procedural Complications ◽  
Previously Treated ◽  
Meningeal Artery

Abstract BACKGROUND Chronic subdural hematoma (SDH) is a particularly challenging pathology due to high recurrence rates (2%-37%) and complex medical comorbidities that tend to afflict the patient population. Recently, there have been several case series published describing the use of middle meningeal artery (MMA) embolization as an alternative to surgery for treatment of new or recurrent chronic SDH. OBJECTIVE To describe our first 60 cases of MMA embolization for chronic SDH. METHODS MMA embolization was performed using angiography, selective microcatheterization of the MMA, and infusion of polyvinyl alcohol particles. Outcomes were assessed clinically and with interval imaging studies at 1 d, 2 wk, and 6 wk postprocedure, and additional intervals as indicated. RESULTS MMA embolization was performed successfully on 60 total SDHs in 49 patients. This includes upfront treatment for new (not previously treated) SDH in 42, for recurrence in 8, and prophylaxis (soon after surgical evacuation) in 10. There were 3 mortalities (unrelated to the procedure), and no procedural complications. Of the 50 nonprophylactic cases, there were 4 (8.9%) cases of recurrence requiring surgical evacuation, and 31 (68.9%) that had resolution or reduction in size >50% of SDH at longest follow-up. Overall, 41 (91.1%) were stable or decreased in size and able to avoid surgery. CONCLUSION MMA embolization may represent a minimally-invasive alternative to surgery for new or recurrent chronic SDH, or as prophylaxis to reduce the risk of recurrence after surgery. Given our encouraging results with a 91% long-term success rate, a large scale clinical trial is warranted.

Calcified chronic subdural hematoma: A case report and literature review

2017 ◽  
Vol 3 (4) ◽  
pp. 220-223
Author(s):  
Zongyu Xiao ◽  
Zongyu Xiao ◽  
Xiaojuan Chen ◽  
Kunzheng Li ◽  
Zhengping Zhang ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Calcified Chronic Subdural Hematoma

Middle Meningeal Artery Embolization as Treatment for Chronic Subdural Hematoma: A Case Series

2017 ◽  
Vol 14 (5) ◽  
pp. 556-562 ◽  
Author(s):  
Thomas W Link ◽  
Srikanth Boddu ◽  
Joshua Marcus ◽  
Benjamin I Rapoport ◽  
Ehud Lavi ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Symptomatic Relief ◽  
Case Series ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Maximum Diameter ◽  
Recurrence Rates ◽  
Surgical Evacuation ◽  
Initial Injury ◽  
Meningeal Artery

Abstract BACKGROUND Traditional treatment for symptomatic subdural hematoma (SDH) has been surgical evacuation, but recurrence rates are high and patients often harbor complex medical comorbidities. Growth and recurrence is thought to be due to the highly friable nature of the vascularized membrane that forms after initial injury. There have been reported cases of middle meningeal artery (MMA) embolization for treatment of recurrent SDH after surgical evacuation with the goal of eliminating the arterial supply to this vascularized membrane. OBJECTIVE To present the first known case series of MMA embolization as upfront treatment for symptomatic chronic SDHs that have failed conservative management in lieu of surgical evacuation. METHODS Five patients with symptomatic chronic SDHs underwent MMA embolization using PVA microparticles at our institution. Size of SDH was recorded in maximum diameter and total volume. RESULTS Four patients underwent unilateral and 1 underwent bilateral MMA embolization successfully. All cases had significant reduction in total volume of SDH at longest follow-up scan: 81.4 to 13.8 cc (7 wk), 48.5 to 8.7 cc (3 wk), 31.7 and 88 to 0 and 17 cc (14 wk, bilateral), 79.3 to 24.2 cc (8 wk), and 53.5 to 0 cc (6 wk). All patients had symptomatic relief with no complications. Histologic analysis of the chronic SDH membrane in a separate patient that required surgery revealed rich neovascularization with many capillaries and few small arterioles. CONCLUSION MMA embolization could present a minimally invasive and low-risk initial treatment alternative to surgery for symptomatic chronic SDH when clinically appropriate.

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