Neurosurgical Aspects of the Parietal Boss in Patients with Chronic Subdural Hematomas

Neurosurgery ◽  
1981 ◽  
Vol 9 (5) ◽  
pp. 531-534 ◽  
Author(s):  
Takashi Iwabuchi ◽  
Tetsuji Sekiya ◽  
Tetsuji Sekiya
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Ct Scanning ◽  
Burr Hole ◽  
Computed Tomographic ◽  
Subdural Hematomas ◽  
Ct Analysis

Abstract There are many modes of trephination for the treatment of chronic subdural hematoma. Angiographic and computed tomographic (CT) analysis of 60 consecutive patients with chronic subdural hematoma indicated that the parietal boss, which is likely to be overlooked by routine CT scanning, is one of the most suitable places for opening a burr hole. Our patients responded satisfactorily to irrigation therapy via a single burr hole in the parietal boss.

scholarly journals International practice variation in postoperative imaging of chronic subdural hematoma patients

2019 ◽  
Vol 131 (6) ◽  
pp. 1912-1919 ◽  
Author(s):  
Alexander F. C. Hulsbergen ◽  
Sandra C. Yan ◽  
Brittany M. Stopa ◽  
Aislyn DiRisio ◽  
Joeky T. Senders ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Subdural Hematoma ◽  
Medical Center ◽  
Chronic Subdural Hematoma ◽  
Ct Scanning ◽  
Burr Hole ◽  
Ct Scans ◽  
Neurological Condition ◽  
Asymptomatic Patients ◽  
Significant Difference

OBJECTIVEThe value of CT scanning after burr hole surgery in chronic subdural hematoma (CSDH) patients is unclear, and practice differs between countries. At the Brigham and Women’s Hospital (BWH) in Boston, Massachusetts, neurosurgeons frequently order routine postoperative CT scans, while the University Medical Center Utrecht (UMCU) in the Netherlands does not have this policy. The aim of this study was to compare the use of postoperative CT scans in CSDH patients between these hospitals and to evaluate whether there are differences in clinical outcomes.METHODSThe authors collected data from both centers for 391 age- and sex-matched CSDH patients treated with burr hole surgery between January 1, 2002, and July 1, 2016, and compared the number of postoperative scans up to 6 weeks after surgery, the need for re-intervention, and postoperative neurological condition.RESULTSBWH patients were postoperatively scanned a median of 4 times (interquartile range [IQR] 2–5), whereas UMCU patients underwent a median of 0 scans (IQR 0–1, p < 0.001). There was no significant difference in the number of re-operations (20 in the BWH vs 27 in the UMCU, p = 0.34). All re-interventions were preceded by clinical decline and no recurrences were detected on scans performed on asymptomatic patients. Patients’ neurological condition was not worse in the UMCU than in the BWH (p = 0.43).CONCLUSIONSWhile BWH patients underwent more scans than UMCU patients, there were no differences in clinical outcomes. The results of this study suggest that there is little benefit to routine scanning in asymptomatic patients who have undergone surgical treatment of uncomplicated CSDH and highlight opportunities to make practice more efficient.

Partial Hydrocephalus with Chronic Subdural Hematoma

Neurosurgery ◽  
1982 ◽  
Vol 11 (5) ◽  
pp. 698-702 ◽  
Author(s):  
Toshiki Yoshimine ◽  
Toru Hayakawa ◽  
Kiyoo Kamikawa ◽  
Toshiteru Ohnishi ◽  
Toshiteru Ohnishi ◽  
...  
Keyword(s):  
Skull Base ◽  
Subdural Hematoma ◽  
Lateral Ventricle ◽  
Chronic Subdural Hematoma ◽  
Adult Patients ◽  
Characteristic Finding ◽  
Computed Tomographic ◽  
Subdural Hematomas

Abstract Two adult patients with unilateral chronic subdural hematomas are reported because of the presence of dilatation of the lateral ventricle opposite the hematoma. In both cases, dilatation was limited to the contralateral atrium and the occipital and temporal horns. The selective dilatation, we believe, is explained on the basis of the anatomy of the skull base and the falx. This phenomenon may contribute to an increase of the supratentorial pressure, originally elevated by the hematoma. This characteristic finding on computed tomographic scans should be regarded as critical in cases of chronic subdural hematoma.

Modified Burr-Hole Craniostomy for the Treatment of Chronic Subdural Hematoma in Adults

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zhiyong Zhao ◽  
Jinglong Zhang ◽  
Guojin Zhang ◽  
Yuntai Cao ◽  
Gang Wang ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Burr Hole

scholarly journals Spontaneous resolution of large non-traumatic bilateral acute-on-chronic subdural hematoma

2017 ◽  
Vol 31 (1) ◽  
pp. 8-16
Author(s):  
D. Adam ◽  
D. Iftimie ◽  
Gina Burduşa ◽  
Cristiana Moisescu
Keyword(s):  
Conservative Treatment ◽  
Subdural Hematoma ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Neurological Status ◽  
Spontaneous Resolution ◽  
Subdural Hematomas ◽  
Gcs Score

Abstract Background and importance: Chronic subdural hematomas are a frequently encountered neurosurgical pathology, especially in the elderly. They often require surgical evacuation, but recent studies have shown good results with conservative treatment in selected cases. Clinical presentation: We report the case of a 72-year old patient that developed large, non-traumatic, bilateral, acute-on-chronic subdural hematoma after repeated abdominal surgery for appendicular carcinoma. He presented an abdominal wound infection and good neurological status (GCS score of 14 points), factors that indicated the delay of surgical intervention. Subsequent clinical and radiological improvement forestalled the operation altogether and he presented complete spontaneous resolution of subdural hematomas at only 5 months after diagnosis. Conclusion: Although surgical treatment is performed in the majority of chronic subdural hematomas, in clinically and radiologically selected cases, the operation can be avoided. The hematoma can present resolution, either spontaneously or with the help of conservative treatment.

scholarly journals A Rare Complication of Chronic Subdural Hematoma Evacuation: Brain Stem Hemorrhage: A Case Report

2018 ◽  
Vol 32 (3) ◽  
pp. 462-465 ◽  
Author(s):  
Ghassen Gader ◽  
Mouna Rkhami ◽  
Maher Ben Salem ◽  
Mohamed Badri ◽  
Kamel Bahri ◽  
...  
Keyword(s):  
Brain Stem ◽  
Subdural Hematoma ◽  
Rare Complication ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Burr Hole ◽  
Sudden Increase ◽  
Vascular Disruption ◽  
Rapid Decompression ◽  
Surgical Modality

Abstract Chronic subdural hematoma (CSDH), which commonly affects the elderly, is one of the most frequent, but also benign neurosurgical pathologies. Burr hole drainage is the standard surgical modality for evacuation of a CSDH. This technique is known to be safe, with low morbidity and mortality rates. However, postoperative complications have occasionally been reported. We report the case of a 70-year-old man who presented a fatal brain stem hemorrhage after burr-hole drainage for unilateral chronic subdural hematoma. Asymmetrical and rapid decompression were thought to be leading to vascular disruption or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem bleeding. Therefore, a slow rate of evacuation of chronic subdural hematomas, as well as rigorous postoperative reanimation, are recommended in order to prevent serious complications.

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