Chronic Subdural Haematoma in the Elderly—A North Wales Experience

2002 ◽  
Vol 95 (6) ◽  
pp. 290-292 ◽  
Author(s):  
Muhammad Asghar ◽  
Vedamurthy Adhiyaman ◽  
M W Greenway ◽  
Bhimal K Bhowmick ◽  
A Bates
Keyword(s):  
Risk Factors ◽  
Subdural Haematoma ◽  
Clinical Presentation ◽  
The Elderly ◽  
Chronic Subdural Haematoma ◽  
Focal Neurological Deficit ◽  
North Wales ◽  
District Hospitals ◽  
Altered Mental State ◽  
Incidence Risk

Chronic subdural haematoma (CSDH) is predominantly a disease of the elderly. Most of the existing data come from studies done several decades ago. We examined the incidence, risk factors, clinical presentation, management and outcome in elderly patients with CSDH by retrospective study of the period 1996–1999 in the three district hospitals of North Wales. 40 cases of CSDH were identified in patients > 65 years, the incidence in this population being 8.2/100000. Falls (57%) and antithrombotic therapy (33%) were the most frequent risk factors. The most common presenting features were altered mental state (52%) and focal neurological deficit (50%). 24 patients (60%) underwent surgical intervention with 4 deaths (17%). In the non-operated group mortality was 7/16 (44%). Most of the deaths in this series were due either to CSDH or to the complications of frailty and poor mobility. Surgery itself was generally successful.

scholarly journals Chronic subdural haematoma in the elderly--a North Wales experience

2002 ◽  
Vol 95 (6) ◽  
pp. 290-292 ◽  
Author(s):  
M. Asghar ◽  
V. Adhiyaman ◽  
M W Greenway ◽  
B. K Bhowmick ◽  
A Bates
Keyword(s):  
Subdural Haematoma ◽  
The Elderly ◽  
Chronic Subdural Haematoma ◽  
North Wales

scholarly journals Clinical presentation of tubal ectopic pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1148
Author(s):  
Kavitha Garikapati ◽  
M. Parvathi Devi ◽  
N. Alekya Goud
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Uterine Cavity ◽  
Expectant Management ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Child Bearing ◽  
Incidence Risk ◽  
Ectopic Pregnancies

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.

Venous thrombosis in the elderly: incidence, risk factors and risk groups

2010 ◽  
Vol 8 (10) ◽  
pp. 2105-2112 ◽  
Author(s):  
M. J. ENGBERS ◽  
A. VAN HYLCKAMA VLIEG ◽  
F. R. ROSENDAAL
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Risk Groups ◽  
The Elderly ◽  
Incidence Risk

scholarly journals Incidence of delirium following hospitalization of elderly people with fractures: risk factors and mortality

2021 ◽  
Vol 55 ◽  
Author(s):  
Brunna Rodrigues de Lima ◽  
Brenda Kelly Gonçalves Nunes ◽  
Lara Cristina da Cunha Guimarães ◽  
Lucenda Fellipe de Almeida ◽  
Valéria Pagotto
Keyword(s):  
Risk Factors ◽  
Elderly People ◽  
Past History ◽  
The Elderly ◽  
High Energy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Death ◽  
Incidence Risk ◽  
One Year

ABSTRACT Objective: To identify the incidence, risk factors for delirium, and its association with death in the elderly hospitalized with fractures. Method: Prospective cohort, with a one-year follow-up of elderly people with clinical or radiological diagnosis of fracture, from an emergency and trauma hospital in the state of Goiás. The outcome delirium was defined by the medical description in the medical record. The predictor variables were demographic, health conditions, and hospitalization complications. A hierarchical multiple analysis was performed using robust Poisson regression, with Relative Risk as a measure of effect. Results: A total of 376 elderly patients were included. The incidence of delirium was 12.8% (n = 48). Risk factors were male gender, age ≥80 years, dementia, heart disease, osteoporosis, chronic obstructive pulmonary disease, high-energy traumas, pneumonia, urinary tract infection, and surgery. The risk of death in the sample was 1.97 times higher (HR: 1.97 95% CI 1.19–3.25) in elderly people with delirium. Conclusion: Delirium had an intermediate incidence (12.8%); the risk of death in this group was about 2 times higher in one year after hospital admission. Demographic factors, past history of diseases, surgery, and complications have increased the risk and require monitoring during hospitalization of elderly people with fractures.

scholarly journals No association between seniority of surgeon and postoperative recurrence of chronic subdural haematoma

2015 ◽  
Vol 97 (8) ◽  
pp. 584-588 ◽  
Author(s):  
I Phang ◽  
R Sivakumaran ◽  
MC Papadopoulos
Keyword(s):  
Risk Factors ◽  
Subdural Haematoma ◽  
Early Stage ◽  
Significant Risk ◽  
Working Hours ◽  
Significant Risk Factor ◽  
Chronic Subdural Haematoma ◽  
Timing Of Surgery ◽  
Related Factors ◽  
Burr Holes

Introduction Neurosurgical trainees should achieve competency in chronic subdural haematoma (CSDH) drainage at an early stage in training. The effect of surgeon seniority on recurrence following surgical drainage of CSDH was examined. Methods All CSDH cases performed at St George’s Hospital in London between March 2009 and March 2012 were analysed. Recurrence was defined as clinical deterioration with computed tomography evidence of CSDH requiring reoperation within six months. The following risk factors were considered: seniority of primary and supervising surgeons, timing of surgery (working hours, outside working hours), patient related factors (age, antiplatelets, warfarin) and operative factors (general vs local anaesthesia, burr holes vs craniotomy, drain use). For recurrent cases, we examined the distance of the cranial opening from the thickest part of the CSDH. Results A total of 239 patients (median age: 79 years, range: 33–98 years) had 275 CSDH drainage operations. The overall recurrence rate was 13.1%. The median time between the initial procedure and reoperation was 16 days (range: 1–161 days). The only statistically significant risk factor for recurrence was antiplatelets (odds ratio: 2.62, 95% confidence interval: 1.13–6.10, p<0.05). Warfarin, grade of surgeon, timing of surgery, type of anaesthesia, type of operation and use of drains were not significant risk factors. In 26% of recurrent CSDH cases, the burr holes or craniotomy flaps were placed with borderline accuracy. Conclusions CSDH drainage is a suitable case for neurosurgical trainees to perform without increasing the chance of recurrence.

scholarly journals Comparative study between single versus double burr-hole drainage of unilateral chronic subdural haematoma

2014 ◽  
Vol 43 (1) ◽  
pp. 13-16 ◽  
Author(s):  
SM Asaduzzaman ◽  
KM Tarikul Islam ◽  
Mohammad Nazrul Hossain ◽  
Md Ruhul Amin ◽  
Md Jahangir Alam ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Subdural Haematoma ◽  
The Elderly ◽  
Chronic Subdural Haematoma ◽  
Burr Hole ◽  
Limb Weakness ◽  
Group A ◽  
Grading Scale ◽  
Group B

Chronic subdural haematoma (CSDH) is defined as the haematoma in the subdural space which tend to occur in the elderly several weeks after head injury. The incidence of CSDH varied from 1.72 per 100,000 inhabitants per year in Finland to 13.1 per 100,000 inhabitants per year in Japan with a peak incidence in the sixth and seventh decade of life. CSDH is a common treatable cause of dementia. The principal techniques used in the treatment of CSDHs are presently burr hole, twist drill craniostomy, craniectomy and craniotomy. The aim of this study was to assess clinical outcome in unilateral chronic subdural haematoma psatients treated by single or double burr-hole drainage. This clinical trial was carried out at the department of neurosurgery, BSMMU from June 2010 to November 2011. A total of 40 consecutive patients with their age ranged from 50 to 70 years with GCS 9 to 13 & haematoma volume greater than 30cc were included in this study and randomly divided into two groups. In group A, patients with chronic subdural haematoma (CSDH) were managed with double burr-hole drainage. In group B, patients were managed with single burr-hole drainage. Clinical outcome was measured on the 1st post operative day, 3rd post operative day and at the time of discharge (usually on the 7th post operative day) and at 1 month follow-up by measuring Glassgow coma scale (GCS), improvement of limb weakness and Markwalder grading scale. In this study double burr-hole drainage and single burr-hole drainage surgery shows equal success in the management of CSDHs. DOI: http://dx.doi.org/10.3329/bmj.v43i1.21370 Bangladesh Med J. 2014 January; 43 (1): 13-16

scholarly journals Chronic subdural haematoma during the COVID-19 lockdown period: late presentation with a longer interval from the initial head injury to the final presentation and diagnosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
David Yuen Chung Chan ◽  
Wai Sang Poon ◽  
Danny Tat Ming Chan ◽  
Wai Kit Mak ◽  
George Kwok Chu Wong
Keyword(s):  
Head Injury ◽  
Functional Outcome ◽  
Subdural Haematoma ◽  
Primary Outcome ◽  
The Elderly ◽  
Late Presentation ◽  
Chronic Subdural Haematoma ◽  
Significant Difference ◽  
Novel Coronavirus ◽  
The Impact

Abstract Background The COVID-19 novel coronavirus is contagious, and the mortality is higher in the elderly population. Lockdown in different parts of the world has been imposed since January 2020. Chronic subdural haematoma (cSDH) has a unique natural history in which symptoms can be non-specific, and the onset is insidious. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation of cSDH. Methods Consecutive adult cSDH patients admitted from 1 March 2020 to 30 April 2020 were reviewed. Exclusion criteria including those who had no definite history of head injury or the diagnosis of cSDH were made from a scheduled follow-up scan. Corresponding data during the same period in 2019 were reviewed for comparison. The primary outcome was the interval between the initial head injury and the final radiological diagnosis of cSDH. Secondary outcomes include Markwalder chronic subdural haematoma grade upon admission, length of stay in the acute hospital, and the modified Rankin scale (mRS) upon discharge. Results For the primary outcome, the average interval between head injury and the diagnosis of cSDH was significantly longer at 56.6 days (49 to 74 days, SD 9.83 days) during the period from March to April 2020, versus 29.4 days (17 to 42 days, SD 8.59 days) in 2019 for the corresponding period (p = 0.00703). There was no significant difference in the functional outcome upon discharge. Conclusions cSDH patients can present late during the COVID-19 lockdown period. The functional outcome was comparable when operations for drainage were timely performed.

scholarly journals Chronic Subdural Haematoma: Systematic Review Highlighting Risk Factors for Recurrent Bleeds

2017 ◽  
Vol 4 (1) ◽  
pp. 16-24
Author(s):  
Mohamed Abdelsadg ◽  
◽  
Avinash Kumar Kanodia ◽  
Athar Abbas ◽  
Asim Sheikh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Subdural Haematoma ◽  
Chronic Subdural Haematoma
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