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

2001 ◽  
Vol 41 (8) ◽  
pp. 371-381 ◽  
Author(s):  
Kentaro MORI ◽  
Minoru MAEDA
Keyword(s):  
Surgical Treatment ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Clinical Characteristics ◽  
Chronic Subdural Hematoma

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

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.

scholarly journals Adjunctive postoperative course of dexamethasone in chronic subdural hematoma: Effect on surgical outcome

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Jibran Tariq ◽  
Sajid Nazir Bhatti
Keyword(s):  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Controlled Trial ◽  
Chronic Subdural Hematoma ◽  
Radiological Outcome ◽  
Postoperative Course ◽  
Creative Commons ◽  
Group 2 ◽  
Group 1

Objectives: To compare the effect of burrhole craniostomy with and without a postoperative course of dexamethasone on recurrence rate of chronic subdural hematoma (CSDH). Methods: The study was conducted at the Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad, from September 2017 till May 2018. Adult patients diagnosed with CSDH and advised burrhole craniostomy were enrolled in this prospective randomized controlled trial. Participants were randomized into Group-1 (receiving two weeks dexamethasone), and Group-2 (no dexamethasone). Clinical assessment and Brain CT were done preoperatively, second postoperative day, sixth and twelfth postoperative week, with outcome assessed at twelfth postoperative week. Complications of treatment and recurrence rate were recorded. Results: Ninety-two (n=92, 46 in each group) patients were enrolled. Improvement in neurological (95.7% vs 93.5%; P=0.646) and radiological outcome (95.7% vs 93.5%; P=0.646) was similar in both groups. Complication rate was higher in Group-1 but not significantly different (58.7% vs 43.5%; P=0.535). Most frequent complication was pneumocephalus, with mortality rate equal (n=one). Recurrence was observed in 2.2% (n=1/46) patients in Group-1 and 4.3% (n=2/46) in Group-2 (P=0.557), which was not statistically significant. Conclusions: Neurological and radiological outcome, and mortality rates were similar in both groups. The recurrence rate was lower and complications slightly higher in Group-1 but these were not statistically significant. doi: https://doi.org/10.12669/pjms.37.7.3374 How to cite this:Tariq J, Bhatti SN. Adjunctive postoperative course of dexamethasone in chronic subdural hematoma: Effect on surgical outcome. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3374 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Chronic subdural hematoma: Surgical treatment and outcome in 104 patients

1997 ◽  
Vol 48 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Ralf-Ingo Ernestus ◽  
Piotr Beldzinski ◽  
Heinrich Lanfermann ◽  
Norfrid Klug
Keyword(s):  
Surgical Treatment ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma

scholarly journals Intracerebral Hemorrhage Immediately Following Surgical Treatment of Chronic Subdural Hematoma

1984 ◽  
Vol 24 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Noboru NAKAHARA ◽  
Toshio MASUZAWA ◽  
Koichi KUNO ◽  
Fumiaki SATO
Keyword(s):  
Surgical Treatment ◽  
Intracerebral Hemorrhage ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma

Cerebrospinal fluid leakage into the subdural space: possible influence on the pathogenesis and recurrence frequency of chronic subdural hematoma and subdural hygroma

2008 ◽  
Vol 108 (2) ◽  
pp. 275-280 ◽  
Author(s):  
Rudolf A. Kristof ◽  
Jochen M. Grimm ◽  
Birgit Stoffel-Wagner
Keyword(s):  
Cerebrospinal Fluid ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Postoperative Recurrence ◽  
Cerebrospinal Fluid Leakage ◽  
Subdural Space ◽  
Subdural Hygroma ◽  
Fluid Leakage ◽  
Csf Leakage

Object The purpose of this study was to clarify whether cerebrospinal fluid (CSF) leakage into the subdural space is involved in the genesis of chronic subdural hematoma (CSDH) and subdural hygroma (SH) and to clarify whether this leakage of CSF into the subdural space influences the postoperative recurrence rate of CSDH and SH. Methods In this prospective observational study, 75 cases involving patients treated surgically for CSDH (67 patients) or SH (8 patients) were evaluated with respect to clinical and radiological findings at presentation, the content of β -trace protein (β TP) in the subdural fluid (βTPSF) and serum (βTPSER), and the CSDH/SH recurrence rate. The βTPSF was considered to indicate an admixture of CSF to the subdural fluid if βTPSF/βTPSER > 2. Results The median β TPSF level for the whole patient group was 4.29 mg/L (range 0.33–51 mg/L). Cerebrospinal fluid leakage, as indicated by βTPSF/βTPSER > 2, was found to be present in 93% of the patients with CSDH and in 100% of the patients with SH (p = 0.724). In patients who later had to undergo repeated surgery for recurrence of CSDH/SH, the βTPSF concentrations (median 6.69 mg/L, range 0.59–51 mg/L) were significantly higher (p = 0.04) than in patients not requiring reoperation (median 4.12 mg/L, range 0.33–26.8 mg/L). Conclusions As indicated by the presence of βTP in the subdural fluid, CSF leakage into the subdural space is present in the vast majority of patients with CSDH and SH. This leakage could be involved in the pathogenesis of CSDH and SH. Patients who experience recurrences of CSDH and SH have significantly higher concentrations of βTPSF at initial presentation than patients not requiring reoperation for recurrence. These findings are presented in the literature for the first time and have to be confirmed and expanded upon by further studies.

Outcome following surgical treatment of chronic subdural hematoma in the oldest-old population

2017 ◽  
Vol 40 (3) ◽  
pp. 527-528 ◽  
Author(s):  
Christopher Munoz-Bendix ◽  
Hans-Jakob Steiger ◽  
Marcel Alexander Kamp
Keyword(s):  
Surgical Treatment ◽  
Subdural Hematoma ◽  
Oldest Old ◽  
Chronic Subdural Hematoma

scholarly journals In Reply: COVID-19 Infection Affects Surgical Outcome of Chronic Subdural Hematoma

Neurosurgery ◽  
2020 ◽  
Vol 87 (2) ◽  
pp. E172-E172
Author(s):  
Giuseppe Talamonti ◽  
Giuseppe D’Aliberti ◽  
Marco Cenzato
Keyword(s):  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Chronic Subdural Hematoma

scholarly journals Trephine Craniotomy versus Burr Hole Drainage for Chronic Subdural Hematoma—An Institutional Analysis of 156 Patients

2020 ◽  
Vol 17 (02) ◽  
pp. 110-120
Author(s):  
Ramesh Chandra Vemula ◽  
B. C.M. Prasad ◽  
Venkat Koyalmantham ◽  
Kunal Kumar
Keyword(s):  
Ct Scan ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Surgical Intervention ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
P Value ◽  
First Choice ◽  
Significant Difference ◽  
Preoperative Ct

Abstract Introduction Some neurosurgeons believe that doing a trephine craniotomy (TC) decreases the chance of recurrence in chronic subdural hematoma (cSDH). But this is not supported by any evidence. Methods A retrospective analysis of patients who were operated for cSDH from 2014 to 2019 at our institute was done. Factors causing recurrence were studied. Results A total of 156 patients were operated in the given period, among which 88 underwent TC and 68 patients underwent burr hole drainage (BHD) for evacuation of cSDH. All patients underwent two trephines or two burr holes placed according to the maximum thickness of the hematoma. Rate of recurrence in trephine group was 12.5% and in burr-hole group was 11.76% and was not statistically significant. Significant factors for recurrence included nontraumatic cSDH, anticoagulant use, presence of membranes, preoperative computed tomography (CT) showing iso- or mixed-density subdural collection and SDH volume > 60 mL. There was selection bias for the procedure. Patients with subdural membranes were preferentially taken for TC as the percentage of subdural membrane found intraoperatively was significantly greater in trephine group (51.1%) than burr-hole group (17.6%) (p value < 0.001).When all the patients who showed membranes in CT scan were excluded, there was no statistical difference in the base line characteristics of both the groups. After excluding the patients with membranes in preoperative CT scan, there was no significant difference in recurrence rate between the two groups.In TC group with membranes, 8 out of 45 had recurrence, whereas in burr-hole group with membranes, 8 out of 12 had recurrence. This difference was statistically significant. (p value < 0.001). Conclusion Surgical intervention in both modalities improves patient outcome with an overall recurrence rate of 12.17%. In the absence of any identifiable membranes in preoperative CT scan, BHD is the preferred surgical intervention. We prefer TC as first choice for patients with membranes in CT scan.

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