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Chronic subdural hematoma

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https://www.readbyqxmd.com/read/28325463/perioperative-management-of-anticoagulation
#1
REVIEW
Daipayan Guha, R Loch Macdonald
Antiplatelet and anticoagulant drugs (antithrombotics) predispose to acute and chronic subdural hematomas. Patients on these drugs are at higher likelihood of presenting with larger hematomas and more severe neurologic deficits. Standard neurosurgical and neurocritical care of subdural hematomas involves reversal of antithrombosis preoperatively, whereas reversing antiplatelet drugs is less clear. This article highlights the spectrum of antithrombotic agents in common use, their mechanisms of action, and strategies for reversal...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325459/natural-history-of-acute-subdural-hematoma
#2
REVIEW
Rafael A Vega, Alex B Valadka
Because published guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are based largely on case series and other weak evidence, management often must be individualized. Nonoperative management is a viable option in many cases. The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas. Close clinical and radiologic follow-up is needed, both acutely to detect rapid expansion of an ASDH, and subacutely to detect formation of a large subacute or chronic subdural hematoma...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#3
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325457/craniotomy-for-treatment-of-chronic-subdural-hematoma
#4
REVIEW
Isaac Josh Abecassis, Louis J Kim
Chronic subdural hematomas are commonly encountered pathologies in neurologic surgery. Primary management for a symptomatic lesion usually entails surgical intervention. There is controversy regarding ideal modality selection among twist drill craniostomy, bur hole craniostomy, and craniotomy. Variations of the craniotomy include a minicraniotomy (usually defined as 30-40 mm diameter), minicraniectomy, and with or without either a partial or full membranectomy. In addition to medical complications, potential surgical complications include recurrence, seizures, intraparenchymal hemorrhage, and infection...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325456/minimally-invasive-surgical-approaches-for-chronic-subdural-hematomas
#5
REVIEW
Ian A Buchanan, William J Mack
Chronic subdural hematomas are one of the most common clinical entities encountered in today's neurosurgical practices owing to an aging population and continued increases in life expectancy. Although there is a role for conservative management, surgical drainage remains the mainstay of current therapy. Regardless of the technique used for hematoma drainage, there is level I evidence to suggest that use of closed-system drainage during the perioperative period significantly decreases the likelihood for hematoma recurrence, length of hospital stay, and mortality...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325455/chronic-subdural-medical-management
#6
REVIEW
David Roh, Michael Reznik, Jan Claassen
Chronic subdural hematomas (cSDHs) that are asymptomatic or have minimal symptoms have become more prevalent, with an increased rate of detection with neuroimaging in the setting of an aging population and increasing use of anticoagulants. These cSDHs have been known to spontaneously resolve, and subsequent efforts have been made to study the role of nonoperative initial medical management strategies in these patients. Current and potential strategies for the medical management of cSDH are discussed.
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325454/chronic-subdural-hematoma-epidemiology-and-natural-history
#7
REVIEW
Wuyang Yang, Judy Huang
This article discusses the epidemiology and natural history of chronic subdural hematoma (CSDH), a common disease prevalent in the elderly population. The incidence of CSDH ranges from 1.72 to 20.6 per 100,000 persons per year. Risk factors include advancing age, male gender, and antiplatelet or anticoagulant use. Clinical progression is separated into 3 distinct periods, including the initial traumatic event, the latency period, and the clinical presentation period. The recurrence of CSDH and nonsurgical predictive factors are described in detail to provide a comprehensive understanding of the outcome of this disease...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#8
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#9
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28300712/flow-liver-flow-a-retrospective-analysis-of-the-interplay-of-liver-disease-and-coagulopathy-in-chronic-subdural-hematoma
#10
John Paul George Kolcun, Joanna Elizabeth Gernsback, Angela Mae Richardson, Jonathan Russell Jagid
BACKGROUND: Chronic subdural hematoma (cSDH) is a common neurosurgical ailment, particularly in the elderly. A recent study uncovered an association between liver disease and recurrence in cSDH patients. Here, we explore that relationship to identify recurrence predictors in at-risk patients. OBJECTIVE: We hypothesized that the association between liver disease and recurrence was due to coagulopathy secondary to liver disease. METHODS: We retrospectively reviewed all cSDH patients treated with burr-hole drainage by two surgeons between 2007-2015...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28287909/clinical-evaluation-of-a-microwave-based-device-for-detection-of-traumatic-intracranial-hemorrhage
#11
Johan Ljungqvist, Stefan Candefjord, Mikael Persson, Lars Jönsson, Thomas Skoglund, Mikael Elam
Traumatic brain injury (TBI) is the leading cause of death and disability among young persons. A key to improve outcome for patients with TBI is to reduce the time from injury to definitive care by achieving high triage accuracy. Microwave technology (MWT) allows for a portable device to be used in the pre-hospital setting for detection of intracranial hematomas at the scene of injury, thereby enhancing early triage and allowing for more adequate early care. MWT has previously been evaluated for medical applications including the ability to differentiate between hemorrhagic and ischemic stroke...
March 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28272701/chronic-subdural-hematoma-management-clarifying-the-definitions-of-outcome-measures-to-better-understand-treatment-efficacy-a-systematic-review-and-meta-analysis
#12
C-S Xu, M Lu, L-Y Liu, M-Y Yao, G-L Cheng, X-Y Tian, F Xiao, Q Wan, F Chen
OBJECTIVE: A long history of inconsistencies in the definitions of the outcome measures for chronic subdural hematomas (CSDHs) has contributed to the controversy over the optimal surgical strategy for CSDH treatment. Clarifying these definitions, reassess the available data, and systematically review the prior literature may provide better insight into the differences in treatment efficacy for CSDH. MATERIALS AND METHODS: The clinical course of CSDH was described with a series of strictly defined outcome measures...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28264245/clinical-course-and-results-of-surgery-for-chronic-subdural-hematomas-in-patients-on-drugs-affecting-hemostasis
#13
Tomasz Andrzej Dziedzic, Przemysław Kunert, Andrzej Marchel
OBJECTIVE: An apparent increase of use of drugs affecting hemostasis in our neurosurgical department since the 1990s has encouraged us to investigate whether these drugs influence the clinical course and results of surgery for chronic subdural hematoma (CSDH). METHODS: This retrospective analysis included 178 patients admitted for CSDH from 2007 to 2011 who were divided into two groups: on drugs affecting hemostasis (40; 22%) and no bleeding disorders (138; 78%)...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28262409/waldenstrom-macroglobulinemia-presenting-as-a-bilateral-subdural-chronic-hematoma
#14
Andrea Franzini, Giulia Gribaudi, Elena Pirola, Mauro Pluderi, Maria Cecilia Goldaniga, Giovanni Marfia, Paolo Maria Rampini
No abstract text is available yet for this article.
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28258932/herbal-medicine-oreongsan-for-recurrent-chronic-subdural-hematoma-a-case-report
#15
Ki-Ho Cho, Seungwon Kwon, Woo-Sang Jung, Sang-Kwan Moon
Recently, the East-Asian herbal complex Oreongsan (Goreisan in Japanese and Wulingsan in Chinese) has been noted for its usefulness in preventing postoperative recurrence of chronic subdural hematoma (CSDH). Here, we present a case of CSDH, an 84-year-old man which had recurred four times, despite three previous burr-hole surgeries. Following the fourth burr-hole surgery, an herbal medicine called Oreongsan (TJ-17, Tsumura, Japan, 15g/d) was administered to the patient in hopes of preventing another CSDH recurrence...
December 18, 2016: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/28249828/embolization-therapy-for-refractory-hemorrhage-in-patients-with-chronic-subdural-hematomas
#16
El Kim
OBJECTIVE: There is no definite operative procedure for patients with intractable chronic subdural hematoma (CSDH). The authors herein described the safety and efficacy of embolization treatment of the middle meningeal artery (MMA) for such cases. METHODS: Patients were divided into an embolization group (n=20) and a conventional group (n=23) based on the therapeutic approach to their CSDHs. Twenty-six recollected hematomas with increased risk of recurrence were the targets of the endovascular treatment...
February 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28224817/is-the-recurrence-rate-of-chronic-subdural-hematomas-dependent-on-the-duration-of-drainage
#17
Aydemir Kale, İbrahim İlker Öz, Eren Görkem Gün, Murat Kalaycı, Şanser Gül
OBJECTIVES: Chronic subdural hematoma (CSDH) is the most frequent type of intracranial hemorrhage which especially affects the elderly. Various surgical techniques have been reported for CSDH treatment; optimal treatment methods are still controversial. In this study, the effects of long drainage durations on results and recurrences were investigated in patients on whom closed system drainage with burr hole craniotomy was applied due to CSDH. METHODS: 90 patients with 105 CSDH were operated between 2008 and 2016...
February 22, 2017: Neurological Research
https://www.readbyqxmd.com/read/28220367/routine-placement-of-subdural-drain-after-burr-hole-evacuation-of-chronic-and-subacute-subdural-hematoma-a-contrarian-evidence-based-approach
#18
Laxminadh Sivaraju, Ranjith K Moorthy, Visalakshi Jeyaseelan, Vedantam Rajshekhar
The objective of this paper was to evaluate whether available evidence supporting placement of subdural drain placement after evacuation of chronic subdural haematoma (CSDH) is applicable to a cohort of patients managed by us. In this observational cohort study, clinical follow-up was obtained in 166 patients who underwent burr hole evacuation of CSDH without placement of subdural drain followed by 3 days of bed rest. The primary outcome studied was recurrence requiring reoperation. Factors predicting recurrence were also analysed...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28217168/idiopathic-bilateral-chronic-subdural-hematoma-with-left-internal-carotid-artery-infarct-in-a-3-months-infant-a-rare-case-report
#19
Mahesh Kumar, Krishan Yadav, Saurabh Kumar Verma, Vikas Maheshwari
Spontaneous chronic subdural hematoma (CSH) in infants is extremely rare. A very limited number of cases are known and reported in literature. The clinical presentation can be myriad varying from asymptomatic cases to gross neurological deficits. We report a case of a 3-month-old child who presented to us with repeated episodes of focal seizures of the left upper and lower limb of 1 month duration. Subsequent imaging revealed bilateral CSH (right > left) with left internal carotid artery infarct and midline shift to left by 8 mm...
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28184348/refractory-spontaneous-chronic-subdural-hematoma-a-rare-presentation-of-an-intracranial-arteriovenous-fistula
#20
El Kim
The author has encountered a 67-year-old man with dural arteriovenous fistula (AVF) presenting as a non-traumatic chronic subdural hematoma (CSDH). This previously healthy patient was hospitalized due to progressive headache with subacute onset. He underwent burr-hole surgery twice for evacuating the left CSDH that was thickest at the posterior temporal area. The operative procedure and finding was not extraordinary, but subdural hematoma slowly progressed for days following the revision surgery. After investigation by super-selective external carotid angiography, a dural AVF found near the transverse-sigmoid sinus was diagnosed...
December 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
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