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 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 Role of brain natriuretic peptide in the prediction of long-term surgical outcome of chronic subdural hematoma

2021 ◽  
Vol 420 ◽  
pp. 117240
Author(s):  
Mehdi Chihi ◽  
Oliver Gembruch ◽  
Marvin Darkwah Oppong ◽  
Laurèl Rauschenbach ◽  
Steffen Rauscher ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Chronic Subdural Hematoma

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.

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

2021 ◽  
Vol 9 (1) ◽  
pp. 44
Author(s):  
Tinu Ravi Abraham ◽  
Shaju Mathew ◽  
P. K. Balakrishnan ◽  
Ajax John ◽  
Haris Thottathil Pareed ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Prognostic Value ◽  
Clinical Characteristics ◽  
Chronic Subdural Hematoma ◽  
Pressure Group ◽  
Midline Shift ◽  
Hematoma Volume ◽  
Ranking Score ◽  
The Mean ◽  
Gcs Score

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.

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

Long-term Functional and Neuropsychological Outcome Following Successful Treatment of Chronic Subdural Hematoma in the Elderly

Neurosurgery ◽  
1999 ◽  
Vol 45 (3) ◽  
pp. 731-731
Author(s):  
Vikram C. Prabhu ◽  
Vincent J. Miele ◽  
Deborah Rettig ◽  
Salli Lewis ◽  
Staci Robyn ◽  
...  
Keyword(s):  
Successful Treatment ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Neuropsychological Outcome

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.

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