Rise of the Double Crescent Sign as a Clinical Predictor of Chronic Subdural Hematoma Recurrence

2021 ◽  
Author(s):  
Emily Ton ◽  
Alexander S Himstead ◽  
Nolan Brown ◽  
Michael Y Oh
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Clinical Predictor ◽  
Crescent Sign

Double-crescent sign as a predictor of chronic subdural hematoma recurrence following burr-hole surgery

2019 ◽  
Vol 131 (6) ◽  
pp. 1905-1911 ◽  
Author(s):  
Koichi Miki ◽  
Hiroshi Abe ◽  
Takashi Morishita ◽  
Shuji Hayashi ◽  
Kenji Yagi ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Imaging Finding ◽  
Past History ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Hematoma Volume ◽  
Independent Predictive Factor ◽  
Space Correlation ◽  
Crescent Sign ◽  
Postoperative Residual

OBJECTIVESubdural hygroma has been reported as a causative factor in the development of a chronic subdural hematoma (CSDH) following a head trauma and/or neurosurgical procedure. In some CSDH cases, the presence of a 2-layered space delineated by the same or similar density of CSF surrounded by a superficial, residual hematoma is seen on CT imaging after evacuation of the hematoma. The aims of the present study were to test the hypothesis that the double-crescent sign (DCS), a unique imaging finding described here, is associated with the postoperative recurrence of CSDH, and to investigate other factors that are related to CSDH recurrence.METHODSThe authors retrospectively analyzed data from 278 consecutive patients who underwent single burr-hole surgery for CSDH between April 2012 and March 2017. The DCS was defined as a postoperative CT finding, characterized by the following 2 layers: a superficial layer demonstrating residual hematoma after evacuation of the CSDH, and a deep layer between the brain’s surface and the residual hematoma, depicted as a low-density space. Correlation of the recurrence of CSDH with the DCS was evaluated by multivariate logistic regression modeling. The authors also investigated other classic predictive factors including age, sex, past history of head injury, hematoma laterality, anticoagulant and antiplatelet therapy administration, preoperative hematoma volume, postoperative residual hematoma volume, and postoperative brain reexpansion rate.RESULTSA total of 277 patients (320 hemispheres) were reviewed. Fifty (18.1%) of the 277 patients experienced recurrence of CSDH within 3 months of surgery. CSDH recurred within 3 months of surgery in 32 of the 104 hemispheres with a positive DCS. Multivariate logistic analyses revealed that the presence of the DCS (OR 3.36, 95% CI 1.72–6.57, p < 0.001), large postoperative residual hematoma volume (OR 2.88, 95% CI 1.24–6.71, p = 0.014), anticoagulant therapy (OR 3.03, 95% CI 1.02–9.01, p = 0.046), and bilateral hematoma (OR 3.57, 95% CI 1.79–7.13, p < 0.001) were significant, independent predictors of CSDH recurrence.CONCLUSIONSIn this study, the authors report that detection of the DCS within 7 days of surgery is an independent predictive factor for CSDH recurrence. They therefore advocate that clinicians should carefully monitor patients for postoperative DCS and subsequent CSDH recurrence.

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

Bilateral Acute Subdural Hematoma Following Evacuation of Chronic Subdural Hematoma

2007 ◽  
Vol 41 (4) ◽  
pp. 267 ◽  
Author(s):  
Seok Won Kim ◽  
Seung Myung Lee ◽  
Ho Shin
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Acute Subdural Hematoma

Independent predictors for functional outcome after drainage of chronic subdural hematoma identified using a logistic regression model

2020 ◽  
Vol 64 (2) ◽  
Author(s):  
Sotirios Katsigiannis ◽  
Christina Hamisch ◽  
Boris Krischek ◽  
Marco Timmer ◽  
Anastasios Mpotsaris ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Functional Outcome ◽  
Subdural Hematoma ◽  
Logistic Regression Model ◽  
Chronic Subdural Hematoma

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.

Acute epidural-like subdural hematoma formation between dura and capsule after bilateral burr-hole drainage of chronic subdural hematoma

2021 ◽  
Author(s):  
Y. Yang ◽  
W. Chen ◽  
H. Mo ◽  
J. Liang ◽  
G. Li ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Hematoma Formation

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

Fibrinolytic-Facilitated Chronic Subdural Hematoma Drainage—A Systematic Review

2021 ◽  
Author(s):  
Yip Mang O ◽  
Shek Long Tsang ◽  
Gilberto Ka-Kit Leung
Keyword(s):  
Systematic Review ◽  
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.

Chronic Subdural Hematoma

1998 ◽  
Vol 88 (5) ◽  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma
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