Current Clinical Standards for the Treatment of Chronic Subdural Hematoma in Austrian, German, and Swiss Neurosurgical Units

2018 ◽  
Author(s):  
D. Baschera ◽  
L. Tosic ◽  
L. Westermann ◽  
J. Oberle ◽  
A. Alfieri
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Clinical Standards

scholarly journals Meningeal Carcinomatosis for Prostate Adenocarcinoma Mimicking Chronic Subdural Hematoma: Case Report and Literature Review

2021 ◽  
Author(s):  
Tiago Silva Holanda Ferreira ◽  
Gilnard Caminha de Menezes Aguiar ◽  
Daniel Gurgel Fernandes Távora ◽  
Lucas Alverne Freitas de Albuquerque ◽  
Stélio da Conceição Araújo Filho
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Specific Antigen ◽  
Chronic Subdural Hematoma ◽  
Radical Resection ◽  
Prostate Adenocarcinoma ◽  
Meningeal Carcinomatosis ◽  
Motor Deficits ◽  
Friable Material ◽  
The Central Nervous System

Abstract Introduction Cerebral metastases are the most common cancer of the central nervous system (CNS). Meningeal infiltration by neoplasms that did not originate in the CNS is a rare fact that is present in 0.02% of the autopsies.Epidemiologically, the radiological presentation mimicking a subdural hematoma is even more uncommon. We report a case of meningeal carcinomatosis by an adenocarcinoma of the prostate mimicking a chronic subdural hematoma. Case Report A 60-year-old male patient was diagnosed with prostate cancer in 2011. He underwent radical resection of the prostate, as well as adjuvant hormonal therapy and chemotherapy.Five years later, the patient presented peripheral facial paralysis that evolved with vomiting and mental confusion. Tomography and magnetic resonance imaging scans confirmed the subdural collection.At surgery, the dura was infiltrated by friable material of difficult hemostasis. The anatomicopathological examination showed atypical epithelial cells. The immunohistochemistry was positive for prostate-specific antigen (PSA) and other key markers, and it was conclusive for meningeal carcinomatosis by a prostate adenocarcinoma. Discussion Meningeal carcinomatosis presents clinically with headache, motor deficits, vomiting, changes in consciousness and seizures.The two most discussed mechanisms of neoplastic infiltration are the hematogenous route and retrograde drainage by the vertebral venous plexus. Conclusion Variable clinical presentations may occur in dural metastases; however, the radiological presentation as subdural hematoma is rare. There are few descriptions of cases like this one in the literature.To support the diagnosis, the previous medical history is as important as the complementary exams and the radiological findings, because the symptoms are common at the neurological emergency. To our knowledge, this is the first report of a prostate neoplasm mimicking chronic subdural hematoma in Brazil.

scholarly journals Two Co(II) coordination polymers: magnetic properties and application values against chronic subdural hematoma

2021 ◽  
Vol 24 (1) ◽  
pp. 199-207
Author(s):  
Jing-Sen Chen ◽  
Sheng-Long Cao ◽  
Hai-Ying Hu ◽  
Juan Shen ◽  
Yu-Jun Qi
Keyword(s):  
Magnetic Properties ◽  
Coordination Polymers ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma

scholarly journals Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 257
Author(s):  
Ambooj Tiwari ◽  
Adam A. Dmytriw ◽  
Ryan Bo ◽  
Nathan Farkas ◽  
Phillip Ye ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Volumetric Analysis ◽  
Primary Therapy ◽  
Curative Therapy ◽  
Complete Obliteration ◽  
Embolization Treatment ◽  
Long Term Follow Up ◽  
Meningeal Artery

Objective: To study the efficacy of middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematoma (SDH) and characterize its post-embolization volumetric resolution. Methods: Ten patients diagnosed with 13 cSDH underwent MMA embolization. SDH volumes were measured from time of initial discovery on imaging to pre-operative, post-operative, short-term and long-term follow-up. Time between procedure to obliteration was also measured. Volumetric analysis was done using the coniglobus formula, and recurrence rate as well as resolution timeline was defined using best-fit models. Results: Out of 10 patients, five were recurrent lesions, three were bilateral and seven unilateral cSDH. Average and median pre-operative volumes were 105.3 cc and 97.4 cc, respectively. Embolization on average was performed 21 days after discovery. Sixty percent of patients had concurrent antiplatelets or anticoagulation use. Forty percent underwent embolization treatment as the primary therapy. Recurrence was not seen in any patients treated with embolization. There were no peri- or post-operative complications. Five patients experienced complete or near-complete obliteration, while those with partial resolution showed a composite average of 75% volumetric reduction in 45 days. Post-embolization, the volumetric resolution followed an exponential decay curve over time and was independent of initial volume. Conclusion: MMA embolization contributed to a marked reduction in SDH volume post-operatively and can be used as a curative therapy for primary or recurrent chronic SDH.

scholarly journals Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis

2021 ◽  
pp. 159101992199096
Author(s):  
Joshua Dian ◽  
Janice Linton ◽  
Jai JS Shankar
Keyword(s):  
Confidence Interval ◽  
Subdural Hematoma ◽  
Meta Analysis ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Control Group ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Invasive Approach ◽  
Risk Of Recurrence

Objective Chronic subdural hematoma (CSDH) is a common and debilitating neurological condition whose treatments, including burr hole drainage and craniotomy, suffer from high rates of recurrence and complication. Embolization of the middle meningeal artery (EMMA) is a promising minimally invasive approach to manage CSDH in a broad set of patients. Methods To evaluate the efficacy and safety of EMMA, a database search was conducted including the terms “subdural hematoma; embolization; embolized; middle meningeal” was performed and yielded a total of 260 results. Following exclusion based on predefined criteria, a total of four studies were identified and outcomes including recurrence rates and complication rates were extracted for analysis. Results Four studies including intervention and control groups were included with a total of n = 888 patients. The relative risk of CSDH recurrence in the EMMA (3.5%) compared to control group (23.5%) was significantly reduced when EMMA was performed (risk ratio = 0.17; 95% confidence interval (CI) 0.05–0.67). In addition, rates of complication were not significantly different between patients with conventional therapy and those who received EMMA (OR = 0.77; 95 confidence interval (CI) 0.3–1.99). Conclusion Based on limited data, EMMA reduces the risk of recurrence by 20% compared to surgical treatment for CSDH.

Sign in / Sign up

Export Citation Format

Share Document