scholarly journals A nomogram for estimating intracranial pressure using acute subdural hematoma thickness and midline shift

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chun-Chih Liao ◽  
Heng-Chun Liao ◽  
Feipei Lai ◽  
Furen Xiao
Keyword(s):  
Intracranial Pressure ◽  
Subdural Hematoma ◽  
Element Model ◽  
Brain Parenchyma ◽  
Lookup Table ◽  
Acute Subdural Hematoma ◽  
Midline Shift ◽  
Numerical Convergence ◽  
Additional Information ◽  
Estimation Formula

AbstractAlthough criteria for surgical treatment of acute subdural hematoma (SDH) have been proposed, interaction exists between SDH, midline shift (MLS), and intracranial pressure (ICP). Based on our half sphere finite-element model (FEM) of the supratentorial brain parenchyma, tools for ICP estimation using SDH thickness (SDHx) and MLS were developed. We performed 60 single load step, structural static analyses, simulating a left-sided SDH compressing the cerebral hemispheres. The Young's modulus was taken as 10,000 Pa. The ICP loads ranged from 10 to 80 mmHg with Poisson's ratios between 0.25 and 0.49. The SDHx and the MLS results were stored in a lookup table. An ICP estimation equation was derived from these data and then was converted into a nomogram. Numerical convergence was achieved in 49 model analyses. Their SDHx ranged from 0.79 to 28.3 mm, and the MLS ranged from 1.5 to 16.9 mm. The estimation formula was log(ICP) = 0.614–0.520 log(SDHx) + 1.584 log(MLS). Good correlations were observed between invasive ICP measurements and those estimated from preoperative SDHx and MLS data on images using our model. These tools can be used to estimate ICP noninvasively, providing additional information for selecting the treatment strategy in patients with SDH.

scholarly journals Midline shift in relation to thickness of traumatic acute subdural hematoma predicts mortality

BMC Neurology ◽  
2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Ronald HMA Bartels ◽  
Frederick JA Meijer ◽  
Hans van der Hoeven ◽  
Michael Edwards ◽  
Mathias Prokop
Keyword(s):  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Midline Shift

scholarly journals Clinical Predictors of outcome in Isolated Traumatic Acute Subdural Hematoma

2018 ◽  
Vol 15 (3) ◽  
pp. 8-13
Author(s):  
Maya Bhattachan ◽  
Ali Niyaf ◽  
Ram K. Shrestha ◽  
Amit Pradhananga ◽  
Gopal Sedain ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Adult Population ◽  
Radiological Finding ◽  
Acute Subdural Hematoma ◽  
Study Patient ◽  
High Morbidity ◽  
Midline Shift ◽  
Clinical Predictors ◽  
Hematoma Volume ◽  
Factors Affecting

Head injury is the major cause of death in young adult population worldwide with associated high morbidity. The objective of this study is to find out the outcome and factors affecting the outcome in isolated traumatic acute subdural hematoma. All patients with isolated acute subdural hematoma presenting within 24 hours of trauma and admitted over a period of 1 year were included in this study. Patient was classified according to Glasgow Coma Scale(GCS) after resuscitation in the emergency department. The outcome of the patient was recorded according to the Glasgow Outcome Scale at the time of discharge and at 3 months after the trauma in follow-up. Statistical analysis was performed to find the correlation between GCS, papillary changes and radiological finding in the form of midline shift and hematoma volume to dichotomized outcome. Out of 38 patients enrolled in the study, 33 patients had favorable outcome. Surgery was performed in 12 patients out of whom 4 patients had unfavorable outcome. GCS score, papillary changes, midline shift and hematoma volume were found to have significant association with the outcome in isolated traumatic acute subdural hematoma. Clinical parameters and radiological parameters can gauge the outcome in isolated traumatic brain injury.

Syndrome of the trephined

2009 ◽  
Vol 111 (4) ◽  
pp. 650-652 ◽  
Author(s):  
Vivek Joseph ◽  
Peter Reilly
Keyword(s):  
Subdural Hematoma ◽  
Skin Flap ◽  
Neurological Status ◽  
Bone Flap ◽  
Acute Subdural Hematoma ◽  
Skull Bone ◽  
Midline Shift ◽  
Scalp Flap ◽  
Dependent Position ◽  
Syndrome Of The Trephined

“Syndrome of the trephined” or “sinking skin flap syndrome” is an unusual syndrome in which neurological deterioration occurs following removal of a large skull bone flap. The neurological status of the patient can occasionally be strongly related to posture. A 77-year-old male patient with an acute subdural hematoma was treated using a hemicraniectomy and evacuation of the hematoma. On the 9th postoperative day there was deterioration in sensorium associated with a sunken scalp flap and worsening midline shift on CT. A significant improvement in sensorium and a filling up of the scalp flap occurred after maintaining the patient's head in a dependent position. The patient subsequently made an excellent recovery following replacement of the bone flap. The pathophysiology of “syndrome of the trephined” or “sinking skin flap syndrome” is reviewed.

scholarly journals Significance of time from injury to surgery in the functional recovery of individuals with traumatic acute subdural hematoma

2019 ◽  
Author(s):  
Shih-Han Chen ◽  
Jui-Ming Sun ◽  
Wen-Kuei Fang
Keyword(s):  
Ct Scan ◽  
Scale Score ◽  
Functional Recovery ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Midline Shift ◽  
Coma Scale ◽  
Poor Recovery ◽  
Recovery Group ◽  
Time From Injury

Abstract Background: The time from injury to surgery (TIS) is critical in the functional recovery of individuals with traumatic acute subdural hematoma (TASDH). However, only few studies have confirmed such notion.Methods: The data of TASDH patients who were surgically treated in Chia-Yi Christian Hospital between January 2008 and December 2015 were collected. The significance of variables, including age, sex, traumatic mechanism, coma scale, midline shift on brain computed tomography (CT) scan, and TIS, in functional recovery was assessed using the student’s t -test, chi-square test, univariate and multivariate models, and receiver operating characteristic (ROC) curve.Results: A total of 37 patients achieved functional recovery (outcome scale score of 4 or 5) and 33 patients had poor recovery (outcome scale score of 1–3) after at least 1 year of follow-up. No significant difference was observed in terms of age, sex, coma scale score, traumatic mechanism, or midline shift on brain CT scan between the functional and poor recovery groups. TIS was found to be significantly shorter in the functional recovery group than in the poor recovery group (145.5±27.0 vs. 181.9±54.5, P-value=0.001). TIS and midline shift ≥10 mm were significant factors for functional outcomes in the multivariate regression models. The analysis of TIS with the ROC curve between these two groups showed that the threshold time for functional recovery in comatose patients and those with TASDH who were surgically treated was 2 hours and 57.5 minutes.Conclusions: TIS is crucial for the functional recovery of TASDH patients who underwent surgery.

Prognostic Factors after Acute Subdural Hematoma

2021 ◽  
Vol 15 (11) ◽  
pp. 2979-2981
Author(s):  
Ali Akbar ◽  
Safdar Hussain Arain ◽  
Mumtaz Ali Narejo ◽  
Najmus Saqib Ansari
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Midline Shift ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
The Mean ◽  
Computed Topography

Background: Acute subdural hematoma is a lesion caused by traumatic brain injury. Computed topography, hematoma thickness and midline shift analysis are important factors in evaluating its prognosis. Aim: To evaluate the factors involved in prognosis of acute subdural hematoma. Study design: Retrospective study Place and duration of study: Department of Neurosurgery, Chandka Medical College Hospital, Larkana from 1st October 2020 to 30the June 2021. Methodology: One hundred patients from both genders and between age 18-55 years were enrolled. Clinical examination and radiological complete examination was done in each patient. Zumkeller Index (ZI) was calculated and Glasgow scoring was performed. Results: The mean age were 44.1±15.8 years with 87% males having major reasoning of head injury as a motor cycle accident. Traumatic brain injury was recorded as >3mm ZI in 10 cases. The mean midline shift was 12.4±6.06 mm with a significant difference between three categories. Conclusion: Midline shift and hematoma thickness are useful predictors of prognosis related to acute subdural hematoma. Keywords: Prognostic factor, Acute subdural hematoma, Computed tomography (CT)

scholarly journals Contralateral extradural hematoma following decompressive craniectomy for acute subdural hematoma (the value of intracranial pressure monitoring): a case report

2014 ◽  
Vol 8 (1) ◽  
Author(s):  
Lucas Crociati Meguins ◽  
Gustavo Botelho Sampaio ◽  
Eduardo Cintra Abib ◽  
Rodrigo Antônio Rocha da Cruz Adry ◽  
Richam Faissal El Hossain Ellakkis ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Subdural Hematoma ◽  
Intracranial Pressure Monitoring ◽  
Acute Subdural Hematoma ◽  
Pressure Monitoring ◽  
Extradural Hematoma

Complication of a large cranial defect

1976 ◽  
Vol 44 (4) ◽  
pp. 506-508 ◽  
Author(s):  
Kamran Tabaddor ◽  
James LaMorgese
Keyword(s):  
Intracranial Pressure ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Content Type ◽  
Cranial Defect ◽  
Early Cranioplasty ◽  
Fine Print

✓ A patient with acute subdural hematoma was successfully treated with hemicraniectomy. He developed contralateral weakness 4 months after surgery which was reversed by cranioplasty. The presumptive mechanism is a gradient between atmospheric and intracranial pressure. Early cranioplasty is suggested to prevent this phenomenon.

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