scholarly journals Management of chronic subdural hematoma: Burr hole versus twist drill – A prospective study

2018 ◽  
Vol 13 (2) ◽  
pp. 319 ◽  
Author(s):  
RamKumar Goyal ◽  
Biswaranjan Nayak ◽  
Rajiv Maharshi ◽  
DebadulalDas Bidhar ◽  
Sunil Panchal ◽  
...  
Keyword(s):  
Prospective Study ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Twist Drill ◽  
A Prospective Study

scholarly journals Chronic Subdural Hematoma A Prospective Study

2018 ◽  
Vol 60 (1) ◽  
pp. 19-23
Author(s):  
Ali K. AL-Shalchy ◽  
Wameedh Q. Abdul-hussein ◽  
Saif S. AL-Musawy
Keyword(s):  
Prospective Study ◽  
Subdural Hematoma ◽  
Early Recognition ◽  
Chronic Subdural Hematoma ◽  
Predisposing Factors ◽  
Burr Hole ◽  
Blood Collection ◽  
Age Group ◽  
A Prospective Study ◽  
Symptoms And Signs

Background: Chronic subdural hematoma is a blood collection in the subdural space for more than 3 weeks from the onset of the bleeding. It is more likely to develop in infancy and after the age of 60 years. The incidence of subdural hematoma is 1- 2 per 100,000 people per year.Objective: To delineate the most common feature aspects of SDH like age, predisposing factors, symptoms and signs and different types of management of the disease.Patients and Methods: A prospective study of 40 patients from the period January 2012 - January 2014, and conducted in Gazi Al-Hariri Hospital of Surgical Specialties, disregarding the age, complaining of chronic subdural hematoma as proved by CT scan. It includes the predisposing factors, the symptoms and signs, the location of hematoma, mode of treatment, complications and the outcome.Results: In this study, the highest incidence of CSDH was above 50 years and the second age group was below 1 year. It was more common in males than females and they were unilateral more than bilateral, as shown by C.T scan which was the most reliable method for diagnosis and assessment.Conclusions: The most suitable treatment was burr hole in the older age group but craniotomy with membranectomy were still performed. In patients below 1 year, subdural peritoneal shunt found to be the method of choice. This study shows that the most common complications are the recurrence and infection. The outcome depends mainly on the early recognition and treatment.Keywords: Chronic subdural hematoma, traumatic brain injury, Burr hole aspiration. ورم دموي تحت الجافية المزمن دراسة مستقبلية  د. علي كامل الشالجي د. وميض قيس عبد الحسين د. سيف سعد الموسوي  الخلاصه: المقدمة: النزف الدموي تحت الام الجافية المزمن هو تجمع الدم في المجال تحت الام الجافية لأكثر من 3 أسابيع من بداية النزف. من المرجح أن تحصل في مرحلة الطفولة وبعد سن 60 عاما. حدوث الورم الدموي تحت الام الجافية هو 1-2 لكل 100,000 شخص سنويا. الهدف من الدراسة: لتعيين المميزات الأكثر شيوعا في النزف الدموي تحت الام القاسية مثل: العمر، والعوامل المؤهلة والأعراض والعلامات وطرق العلاج. مرضى وطرق: دراسة مستقبلية من 40 مريضا من الفترة يناير 2012 - يناير 2014، وأجريت في مستشفى غازي الحريري للتخصصات الجراحية، بغض النظر عن العمر، والذين يشكون من ورم دموي تحت الام الجافية المزمن مشخص بالاشعة المقطعية. وتشمل العوامل المؤهلة، والأعراض والعلامات، وموقع الورم الدموي، وطريقة العلاج، والمضاعفات والنتيجة. النتائج: في هذه الدراسة كانت أعلى نسبة للمرضى الذين تتجاوز اعمارهم أكثر من 50 سنة، وكانت الفئة العمرية الثانية الاكثر شيوعا هي الأقل من 1 سنة. وكان الذكور أكثر شيوعا من الإناث وكانت في جهة واحدة أكثر من الثنائية، كما هو مبين من قبل الاشعة المقطعية التي كان الأسلوب الأكثر موثوقية للتشخيص والتقييم. الاستنتاجات: وكان العلاج الأنسب تثقيب الجمجمة في الفئة العمرية الأكبر سنا ولكن فتح الجمجمة مع استئصال الغشاء لا تزال تنفذ. في المرضى الذين تقل أعمارهم عن 1 سنة، وجدت تحويلة تحت الجافية بريتونية لتكون الطريقة المفضلة. وتبين هذه الدراسة أن المضاعفات الأكثر شيوعا هي التكرار والعدوى. النتيجة تعتمد أساسا على التشخيص المبكر والعلاج. التوصيات: تثقيب الجمجمة يجب ان تكون النهج الجراحي الرئيسي في العلاج للمرضى مع اعطاء علاج الستيرويد لتقليل إمكانية التكرار. مفتاح الكلمات: ورم دموي تحت الام الجافية المزمن، وإصابات الدماغ الصدامية، بزل ثقوب الجمجمة.

Chemokines as markers of local inflammation and angiogenesis in patients with chronic subdural hematoma: a prospective study

2011 ◽  
Vol 154 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Milo Stanisic ◽  
Staale Petter Lyngstadaas ◽  
Are Hugo Pripp ◽  
Ansgar Oddne Aasen ◽  
Karl-Fredrik Lindegaard ◽  
...  
Keyword(s):  
Prospective Study ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Local Inflammation ◽  
A Prospective Study

Twist Drill Craniostomy and Closed System Drainage of Chronic and Subacute Subdural Hematomas

Neurosurgery ◽  
1983 ◽  
Vol 13 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Candace K. Carlton ◽  
Richard L. Saunders
Keyword(s):  
Prospective Study ◽  
Ct Scan ◽  
Closed System ◽  
Chronic Subdural Hematoma ◽  
Twist Drill ◽  
Computed Tomographic ◽  
Subdural Hematomas ◽  
Initial Procedure ◽  
A Prospective Study ◽  
Length Of Hospitalization

Abstract Based on reports in the literature on the success and low morbidity of twist drill craniostomy (TDC) and closed system drainage (CSD) for chronic subdural hematomas, a prospective study was initiated in 1981 and included all symptomatic patients presenting with a history and clinical and computed tomographic (CT) findings consistent with subacute or chronic subdural hematoma. A total of nine patients were treated with TDC and CSD as the initial procedure. An asymptomatic or progressively improving patient with greater than 50% reduction in subdural size by repeat CT scan was set as the end point of therapy. There were no complications, all patients improved with drainage, and seven were cured by this method alone. The results are compared retrospectively to surgically treated patients, and an overall decrease in morbidity and length of hospitalization are noted. The technique and CT scan correlations are described, and the rationale for use of this method is discussed in terms of our current understanding of the pathophysiology and complications of the disease.

Local and systemic pro-inflammatory and anti-inflammatory cytokine patterns in patients with chronic subdural hematoma: a prospective study

2012 ◽  
Vol 61 (8) ◽  
pp. 845-852 ◽  
Author(s):  
Milo Stanisic ◽  
Ansgar Oddne Aasen ◽  
Are Hugo Pripp ◽  
Karl-Fredrik Lindegaard ◽  
Jon Ramm-Pettersen ◽  
...  
Keyword(s):  
Prospective Study ◽  
Subdural Hematoma ◽  
Inflammatory Cytokine ◽  
Chronic Subdural Hematoma ◽  
Anti Inflammatory ◽  
A Prospective Study ◽  
Anti Inflammatory Cytokine

Endoscopic Management of Chronic Subdural Hematoma

2020 ◽  
Vol 81 (04) ◽  
pp. 330-341
Author(s):  
Yad Ram Yadav ◽  
Shailendra Ratre ◽  
Vijay Parihar ◽  
Jitin Bajaj ◽  
Mallika Sinha ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Skin Incision ◽  
Burr Hole ◽  
Endoscopic Technique ◽  
Endoscopic Management ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Duration Of Surgery ◽  
A Prospective Study

Abstract Background Twist drill evacuation, burr hole aspiration, mini-craniotomy, and craniotomy are some of the surgical methods to remove chronic subdural hematoma (CSDH). Endoscopic treatment was also recently found to be useful. Methods We conducted a prospective study of 72 hematomas in 68 patients. Computed tomography was performed in all cases. Endoscopic surgery was performed in all CSDH patients. Surgical procedure A 4-cm skin incision was performed at the most curved part of skull with the CSDH. A mini-craniotomy or enlarged burr hole was made. The inner and outer table of the burr hole margin was drilled to provide a straight trajectory to the hematoma cavity. An endoscope supported by a telescope holder was used. A modified silicone brain retractor was used in five patients. A subgaleal drain was left in all patients for 3 to 5 days. Results There were 42 male and 26 female patients. The age ranged from 45 to 79 years (average: 69 years). All patients had a history of head trauma. Preoperative average Glasgow Coma Scale Score was 14. The procedure was effective in hematoma evacuation and a good visualization of the whole cavity in all patients. The endoscopic technique helped in complete hematoma removal in organized/solid clot, septations, and bridging vessels in 17, 2, and 2 cases, respectively. Duration of surgery ranged from 35 to 80 minutes. One death occurred. There was no recurrence, infection, fresh bleed, or injury to the brain or membrane. Conclusion The endoscopic technique is an effective alternative technique for treating CSDH. Although the study has limitations because of the small number of patients with a short follow-up, the study indicated that thick and vascular membranes, septations, and organized and solid clots can be removed effectively using this technique.

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