Chronic subdural hematoma pressure measurement and its correlation with clinical characteristics and postoperative neurological outcome

Background: The pressure of the chronic SDH (subdural haemotoma), the age of the patient, preoperative GCS score and midline shift were considered prognostic dependent factors. The study aimed at the significance of the pressure of chronic SDH in the outcome of patients.Methods: A correlation between subdural hematoma pressure and preoperative and postoperative clinical variables such as hematoma volume, midline shift, age, GCS score and postoperative modified ranking scale score as well as complications were assessed and analyzed.Results: According to the pressure of chronic SDH, 56 patients were grouped into 4 groups. In the pressure group <15 cm/h20 group the mean age was 85 and postoperative ranking score was 3 and the recurrence was 21 % while in high pressure group (>25 cm/h20) the mortality was 14% and no recurrence.Conclusions: The pressure of the chronic SDH has significant prognostic value in chronic SDH surgeries.

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Subdural Hematoma: A Rare Presentation of a Convexity Meningioma

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100018576 ◽

2014 ◽

Vol 41 (4) ◽

pp. 506-507 ◽

Cited By ~ 2

Author(s):

David Pelz ◽

Adrian B. Levine ◽

Keith W. MacDougall

Keyword(s):

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Past Medical History ◽

Midline Shift ◽

Resonance Imaging ◽

Rare Presentation ◽

History Of ◽

Ct Head ◽

Magnetic Resonance Imaging Mri ◽

Gcs Score

A 69-year-old male presented to a peripheral emergency department with a several day history of increasing confusion and headache. On admission, his Glasgow Coma Scale (GCS) score was 10 (E3 M6 V1). He was mute but would obey commands intermittently. Cranial nerve exam was normal and there was no evidence of weakness. A computed tomogram (CT) head (Figure 1) showed a chronic subdural hematoma with midline shift, as well as a mass within the left frontal region that appeared consistent with a convexity meningioma seen on magnetic resonance imaging (MRI) two years prior (Figure 2). The patient was not on any blood thinners and had no history of falls. Past medical history also included hypertension and prostate cancer.

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Surgical Treatment of Chronic Subdural Hematoma: Clinical Characteristic, Surgical Outcome, Complication and Recurrence Rate

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i05/1115 ◽

2021 ◽

Vol 6 (05) ◽

pp. 292-303

Author(s):

Dr. Vipul Kumar Gupta ◽

Dr. Akshay Gupta

Keyword(s):

Surgical Treatment ◽

Recurrence Rate ◽

Subdural Hematoma ◽

Surgical Outcomes ◽

Surgical Outcome ◽

Clinical Characteristics ◽

Chronic Subdural Hematoma ◽

Neurological Status ◽

Gcs Score

Background: Chronic subdural hematoma is one of the most frequent neurosurgical conditions encountered in elderly people (usually, after minor head trauma) and in patients on long term anticoagulation and long term hemodialysis. The aims of this study is to evaluate the clinical characteristics found in chronic subdural hematoma patients & the surgical outcomes, complications and recurrence rate in chronic subdural hematoma patients. Method: A prospective study of surgical treatment of chronic subdural hematoma, clinical characteristics, surgical outcomes, complication and recurrence rate was done over a period of 2 months between 1st June, 2020 and 31st July, 2020 at GMC Jammu. Result: A total of 35 patients of chronic subdural hematoma, 28 males and 7 females underwent surgery. Maximum were in the age group range of 66-70 years and 81-85 years. 20 cases developed SDH after trauma (due to fall) and 15 cases developed spontaneous SDH. The most common presenting complaint of patients seen in our study was hemiplegia/hemiparesis in 26 cases followed by headache in 15 cases. 10 cases were found to have bilateral hematoma. The most common post-operative complication observed was reaccumulation of hematoma seen in 4 cases. In our study out of 35 patients 27 had GCS score of 15. These patients were discharged home earlier post-operatively, with good outcome. Surgical outcome was good in 100% cases & 0% surgical mortality was observed. Conclusion: Burr hole evacuation for chronic subdural hematoma provides significant improvements is neurological status and good outcomes with 0% mortality observed in our study.

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Kernohan-Woltman notch phenomenon and intention tremors in case of chronic subdural hematoma

Romanian Neurosurgery ◽

10.2478/romneu-2014-0013 ◽

2014 ◽

Vol 21 (1) ◽

pp. 109-112

Author(s):

P. Sasikala ◽

Bindu Menon ◽

Amit Agarwal

Keyword(s):

Ct Scan ◽

Movement Disorders ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Mass Effect ◽

Midline Shift ◽

Rare Presentation ◽

Surgical Evacuation ◽

Significant Mass Effect ◽

Significant Mass

Abstract Movement disorders are atypical and rare presentation of chronic subdural hematomas. We report a case of 60 year man who presented with intention tremors and altered sensorium. The patient had Kernohan-Woltman notch phenomenon on clinical examination. CT scan brain showed a large left fronto-temporo-parietal chronic subdural hematoma with significant mass effect and midline shift. His symptoms relieved completely after surgical evacuation of the hematoma.

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

Romanian Neurosurgery ◽

10.1515/romneu-2017-0002 ◽

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.

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Clinical Predictors of outcome in Isolated Traumatic Acute Subdural Hematoma

Nepal Journal of Neuroscience ◽

10.3126/njn.v15i3.23270 ◽

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.

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Comparative Study of Surgical Outcome of Chronic Subdural Hematoma Treated with and without External Drainage

Eastern Green Neurosurgery ◽

10.3126/egn.v2i1.27459 ◽

2020 ◽

Vol 2 (1) ◽

pp. 30-34

Author(s):

Suresh Sapkota ◽

Kiran Niraula ◽

Subash Lohani ◽

Shikher Shrestha ◽

Bibhusan Shrestha ◽

...

Keyword(s):

Local Anesthesia ◽

Subdural Hematoma ◽

Surgical Outcome ◽

Chronic Subdural Hematoma ◽

Burr Hole ◽

Midline Shift ◽

External Drainage ◽

Presenting Symptoms ◽

Number Of Patients ◽

Significant Difference

Background and purpose: Chronic subdural hematoma (cSDH) poses a significant morbidity and mortality risk particularly in elderly population. It can be treated with simple surgical techniques like burr hole drainage under local anesthesia, however it often recurs after surgical evacuation in significant number of patients. Material and methods: A randomized controlled trial was designed at Mayo Hospital/KEMU in 2013 to 2016. Total number of 98 patients who met the inclusion and exclusion criteria were randomized into ‘with drain’ and ‘without drain’ arm. All of them were treated with burr hole drainage under local anesthesia. Half of them had subdural drain while the remaining half did not. Recurrence of hematoma and surgical outcome was compared. Result: Among 98 patients included in the study(54 males and 44 females) met the inclusion criteria. Mean age of presentation was 63 years ± 12.4 (range 40-100). There was left sided preponderance in hematoma location (53.1%). Mean midline shift was 2.7 mm ± 1.5. Owing to drainage of cSDH, post-operative MRC score of patients along with midline shift in the CT brain showed statistically significant improvement. However, irrespective of insertion of drainage system, there was no significant difference noted in recurrence of cSDH, midline shift and improvement in presenting symptoms (hemiparesis or monoparesis) considering all post-operative days. Conclusion: There is no significant difference in recurrence rate depending on weather a postoperative external drainage is placed or not.

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Surgical Treatment of Chronic Subdural Hematoma in 500 Consecutive Cases: Clinical Characteristics, Surgical Outcome, Complications, and Recurrence Rate.

Neurologia medico-chirurgica ◽

10.2176/nmc.41.371 ◽

2001 ◽

Vol 41 (8) ◽

pp. 371-381 ◽

Cited By ~ 250

Author(s):

Kentaro MORI ◽

Minoru MAEDA

Keyword(s):

Surgical Treatment ◽

Recurrence Rate ◽

Subdural Hematoma ◽

Surgical Outcome ◽

Clinical Characteristics ◽

Chronic Subdural Hematoma

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Treatment of chronic subdural hematoma by twist-drill craniostomy with continuous catheter drainage

Journal of Neurosurgery ◽

10.3171/jns.1986.65.2.0183 ◽

1986 ◽

Vol 65 (2) ◽

pp. 183-187 ◽

Cited By ~ 85

Author(s):

Mark Camel ◽

Robert L. Grubb

Keyword(s):

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Total Mortality ◽

Clinical Syndrome ◽

Twist Drill ◽

Catheter Drainage ◽

Content Type ◽

Excellent Outcome ◽

Duration Of Hospitalization ◽

The Mean

✓ The case records of 114 patients were reviewed to ascertain the efficacy of bedside twist-drill craniostomy and continuous closed-system catheter drainage for the treatment of chronic subdural hematomas. Ninety-eight (86%) patients achieved an excellent outcome, and seven (6%) had no significant improvement. The total mortality from all causes was 8% in this group. Successful catheter drainage of the chronic subdural hematoma was accomplished by either one or two catheter placements in 102 (90%) patients. Twelve patients required additional operative procedures. The mean duration of hospitalization for the study group was 16 ays. No infections occurred in these patients. Remission of the clinical syndrome did not require the adiographic resolution of the chronic subdural hematoma.

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