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Chronic subdural hematoma

Dana C Holl, Victor Volovici, Clemens M F Dirven, Wilco C Peul, Fop van Kooten, Korné Jellema, Niels A van der Gaag, Ishita P Miah, Kuan H Kho, Heleen M den Hertog, Hester F Lingsma, Ruben Dammers
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the more frequent pathological entities in daily neurosurgical practice. Historically, CSDH was considered a progressive, recurrent bleeding with a traumatic etiology. However, recent evidence suggests a complex intertwined pathway of inflammation, angiogenesis, local coagulopathy, recurrent microbleeds and exudates. The aim of the present review is to collect existing data on pathophysiology of CSDH in order to direct further research questions aiming to optimize treatment for the individual patient...
May 14, 2018: World Neurosurgery
Kiyoharu Shimizu, Takashi Sadatomo, Takeshi Hara, Shumpei Onishi, Kiyoshi Yuki, Kaoru Kurisu
AIM: The present study aimed to clarify the relationship between frailty and prognosis of patients with chronic subdural hematoma. METHODS: This retrospective study involved 211 patients aged ≥65 years with chronic subdural hematoma, who underwent surgery at Higashihiroshima Medical Center, Hiroshima, Japan, between July 2011 and May 2017. The study outcome was the patient's modified Rankin Scale score at 3 months after surgery. A logistic regression analysis was carried out to analyze factors that influenced the outcome...
May 17, 2018: Geriatrics & Gerontology International
Reo Kawaguchi, Koji Osuka, Masahiro Aoyama, Shigeru Miyachi, Masakazu Takayasu
Eosinophils induce inflammation by releasing cytokines and cytotoxic granule proteins. Infiltration of eosinophilic granulocytes occurs in the outer membrane of chronic subdural hematomas (CSDHs). Eosinophils play an important role in the growth of CSDHs. However, the manner in which eosinophils accumulate within CSDH fluid remains undetermined. In the current study, we assessed the expression of eosinophil chemoattractants in CSDH fluids according to the growth stage of the CSDHs and examined the correlation between the two...
May 15, 2018: Journal of Neurotrauma
Shuhei Kawabata, Shoichi Tani, Hirotoshi Imamura, Hidemitsu Adachi, Nobuyuki Sakai
The precise mechanism of the development of chronic subdural hematoma (CSDH) as a postoperative complication after aneurysmal clipping remains unclear. The purpose of this study was to identify the independent risk factors for CSDH after craniotomy for aneurysmal clipping and to elucidate the relationship between CSDH and subdural air (SDA) collection immediately after surgery. The medical records and radiologic data of 344 patients who underwent surgical clipping of unruptured aneurysms from July 2010 to July 2016 were retrospectively evaluated...
May 11, 2018: Neurologia Medico-chirurgica
Pasquale De Bonis, Simone Olei, Lorenzo Mongardi, Michele Alessandro Cavallo, Mariaconsiglia Santantonio, Gianluca Trevisi, Carmelo Anile, Annunziato Mangiola
OBJECTIVE: Chronic subdural hematoma (CSDH) is a common condition in the elderly, and the ageing of population will increase the number of "superaged" patients presenting this pathology for the years to come. Few studies investigating the outcome of superaged patients surgically treated for CSDH are available, and study populations are generally small. The outcome of surgically treated patients and risk factors are not completely clear. Aim of the work is to identify the risk factors which may influence the outcome of patients aged 80 years and older surgically treated for CSDH...
May 3, 2018: Clinical Neurology and Neurosurgery
Erin D'Agostino, Vyacheslav Makler, David F Bauer
Background: Epidural abscess (EDA) is an uncommon form of intracranial infection that generally presents with fever, headache, and focal neurologic deficit. Imaging generally reveals a lentiform collection with diffusion restriction on diffusion weighted image. We present an interesting case in which a patient with EDA presented with three weeks of depression with suicidal ideations. The patient displayed no notable infectious signs and the imaging was suggestive of chronic subdural hematoma (SDH) rather than EDA...
2018: Surgical Neurology International
Jeong-Han Kang, Seung Kon Huh, Jinna Kim, Keun Young Park, Joonho Chung
OBJECT: We evaluated the clinical course and significance of postoperative subdural fluid collection (SFC), and identified the patients who were at risk of developing postoperative chronic subdural hematoma (CSDH) after the clipping of unruptured intracranial aneurysms (UIAs). METHODS: Between January 2012 and June 2014, we retrospectively reviewed 298 patients with UIAs treated by microsurgical clipping. Among them, 257 patients were enrolled in the present study...
May 3, 2018: World Neurosurgery
Wenchao Lu, Hui Wang, Tao Wu, Xudong Sheng, Zhibin Ding, Gangzhu Xu
OBJECTIVE: To investigate the effect of burr-hole craniostomy with T-tube drainage to treat chronic subdural hematoma(CSDH). METHODS: Eighty-seven patients with CSDH that were recruited from January 2012 to June 2017 at the Department of Neurosurgery, The First Affiliated Hospital of Xi'an Medical University, were divided into two groups according to the method of drainage: T-tube drainage system (n = 45)and conventional subdural drainage system (n = 42). Retrospective analysis of clinical data and efficacy was performed between the two groups...
May 2, 2018: World Neurosurgery
Adriaan R E Potgieser, J Marc C van Dijk, Jan D M Metzemaekers
No abstract text is available yet for this article.
May 4, 2018: Journal of Neurosurgery
Mehmet Turgut
No abstract text is available yet for this article.
May 4, 2018: Journal of Neurosurgery
Thomas Beez, Ann Kristin Schmitz, Hans-Jakob Steiger, Christopher Munoz-Bendix
Subdural fluid collections are frequently encountered in young children after non-accidental injury. In a subset of patients, these collections progress in size and ultimately require permanent drainage, which is commonly achieved with subdural-peritoneal shunts. However, excessive protein and cellular contents in the fluid are potential risk factors for shunt failure. Here, we describe the adaptation of an endoscopic lavage technique established for ventricular endoscopy with the aim of improving fluid condition prior to shunting...
March 2, 2018: Curēus
Thomas W Link, Benjamin I Rapoport, Stephanie M Paine, Hooman Kamel, Jared Knopman
Background and purpose Embolization of the middle meningeal artery (MMA) has recently been proposed as an alternative to surgery for treatment of chronic subdural hematoma (SDH), and several case reports have been published supporting its efficacy. It has been suggested that the primary pathologic process in chronic SDH is repeated microhemorrhaging into the subdural collection from fragile neovasculature within the SDH membrane that arises from distal branches of the MMA. Embolization could thus provide a means of eliminating this chronic rebleeding...
January 1, 2018: Interventional Neuroradiology
You-Sub Kim, Sung-Pil Joo, Dong-Jun Song, Sung-Hyun Kim, Tae-Sun Kim
RATIONALE: A subdural empyema (SDE) following burr hole drainage of a chronic subdural hematoma (CSDH) can be difficult to distinguish from a recurrence of the CSDH, especially when imaging data is limited to a computed tomography (CT) scan. PATIENTS CONCERNS: All patients underwent burr hole drainage of the CSDH at first, and the appearance of the SDE occurred within one month. DIAGNOSES: A contrast-enhanced magnetic resonance imaging (MRI) scan, with diffusion-weighted imaging (DWI), revealed both the SDE and diffuse meningitis in all patients...
May 2018: Medicine (Baltimore)
Aikaterini Solomou, Pantelis Kraniotis, George Bonanos, Constantine Constantoyannis
A 69-year-old man was admitted to the emergency department with headache and dizziness. He was submitted to brain computed tomography (CT) which showed a tumor in the right cerebellar hemisphere, findings which were subsequently confirmed with magnetic resonance imaging (MRI). He underwent a paramedian suboccipital craniotomy for removal of the mass. Histology confirmed the presence of a hemangiopericytoma. The patient was discharged 5 days postoperatively with improvement in his symptoms. Fifteen days later, he presented with gait difficulties...
April 2018: Journal of Neurological Surgery Reports
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Nursing
Ninh B Doan, Mohit Patel, Ha Son Nguyen, Hayley Doan, Andrew Montoure, Saman Shabani, Michael Gelsomino, Karl Janich
Chronic subdural hematoma (CSDH) is a relatively common condition encountered in a neurosurgical practice. There have been increased efforts in creating different treatment regimens for CSDH to improve patients' outcomes, including the addition of tissue plasminogen activator (tPA) in drains to reduce recurrences. Here, we present the first case report of the safe use of tPA in conjunction with an Integra Camino bolt for maximized drainage of CSDH with a successful neurological recovery and the complete resolution of the hematoma...
April 2018: Asian Journal of Neurosurgery
Ninh B Doan, Ha Nguyen, Karl Janich, Andrew Montoure, Patel Mohit, Saman Shabani, Michael Gelsomino, Wade M Mueller, Shekar Kurpad
Chronic subdural hematoma (cSDH) is a common neurosurgical pathology associated with older age and complicated by antiplatelet/anticoagulant therapies. With improving medical care in an aging population, the incidence of cSDH will likely increase over the next 25 years, placing a burden on health care costs. Consequently, a simple and inexpensive treatment option is desirable. As such, we report a basic, but novel, technique to drain cSDH with an Integra Camino bolt. This technique was employed in two patients, where the significant resolution of cSDH and associated clinical symptoms were observed without complications...
April 2018: Asian Journal of Neurosurgery
Shunsaku Goto, Kyozo Kato, Taiki Yamamoto, Shinji Shimato, Tomotaka Ohshima, Toshihisa Nishizawa
Background: Burr-hole irrigation surgery is now recognized as a widespread simple technique for the treatment of chronic subdural hematoma (CSDH). However, recurrence of CSDH is sometimes experienced after initial surgery. Recently, it has been reported that goreisan is effective in preventing CSDH recurrence. Materials and Methods: Methods: We studied patients with CSDH who received burr-hole irrigation at our hospital between January 2011 and December 2014. We divided these patients into three groups...
April 2018: Asian Journal of Neurosurgery
Ram Kumar Goyal, Biswaranjan Nayak, Rajiv Maharshi, Debadulal Das Bidhar, Sunil Panchal, Harish Chandra Pathak
Introduction: Incidence of chronic subdural hematoma (CSDH) is about 5/100,000/year in the general population and still rising. Two surgical techniques, namely, burr-hole evacuation (BHE) versus twist-drill evacuation (TDE) are commonly used to manage such patients but the preferred surgical method continues to attract debate, and the time for an evidence-based approach is now overdue. In vogue with recent trends, a minimally invasive surgical approach is considered as best; therefore, we tried to establish the hypothesis that TDE is as safe and as effective as BHE for CSDH treatment...
April 2018: Asian Journal of Neurosurgery
Edward Christopher, Michael T C Poon, Laurence J Glancz, Peter J Hutchinson, Angelos G Kolias, Paul M Brennan
Increasing age and lower pre-operative Glasgow coma score (GCS) are associated with worse outcome after surgery for chronic subdural haematoma (CSDH). Only few studies have quantified outcomes specific to the very elderly or comatose patients. We aim to examine surgical outcomes in these patient groups. We analysed data from a prospective multicentre cohort study, assessing the risk of recurrence, death, and unfavourable functional outcome of very elderly (≥ 90 years) patients and comatose (pre-operative GCS ≤ 8) patients following surgical treatment of CSDH...
April 21, 2018: Neurosurgical Review
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