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Chronic subdural hematoma

Samuel Hall, Eleanor Walshe, Claudia Ajayi, Kevin Boyle, Colin Griffith
Background: Herbal supplements are commonly used, however, their side-effect profiles are poorly understood and not subject to the same scrutiny as prescribed medications. Some herbal supplements such as St Johns' Wort are accepted to interfere with clotting pathways, however others, including Red Clover have theoretical bleeding risks based on coumarin content with very little underlying evidence. Case Description: This case reports a 65-year-old woman who suffered a spontaneous acute-on-chronic subdural hemorrhage with a significant postoperative re-hemorrhage...
2018: Surgical Neurology International
Wendong You, Yuanrun Zhu, Yadong Wang, Wenchao Liu, Hao Wang, Liang Wen, Xiaofeng Yang
BACKGROUND: Chronic subdural hematoma (CSDH) is a common disease in neurosurgical practice with substantial recurrence rate. We aimed to estimate recurrence rate of CSDH and to identify risk factors for CSDH recurrence. METHODS: We retrospectively studied consecutive cases with CSDH and performed surgical therapy in our hospital. Univariate and multivariate logistic regression analyses were performed to identify factors associated with recurrence of CSDH. RESULTS: A total of 226 patients with CSDH were included; 34 patients recurred after surgery with a recurrence rate of 15...
March 12, 2018: Acta Neurochirurgica
Guangming Wang, Jinlu Yu
INTRODUCTION: Chronic subdural hematoma(CSDH) can be treated by a relatively simple burr hole surgery. Acute subarachnoid hemorrhage (SAH) occurring after surgery for CSDH has been reported as a rare but severe complication. CASE REPORT: An 88-year-old female complained of progressive headache and dizziness for one month. A right fronto-temporo-parietal CSDH with a shift in the midline structures and lateral ventricle compression was shown by computed tomography (CT) scans...
March 3, 2018: International Journal of Surgery Case Reports
James K C Liu
BACKGROUND: Intracranial hypotension from cerebrospinal fluid hypovolemia resulting in cerebral herniation is a rare but known complication that can occur following neurosurgical procedures, usually encountered in correlation with perioperative placement of a lumbar subarachnoid drain. Decrease in CSF volume resulting in loss of buoyancy results in downward herniation of the brain without contributing mass effect, causing a phenomenon known as 'brain sag.' Unreported previously is brain sag occurring without concomitant occult CSF leak or lumbar drainage...
March 7, 2018: World Neurosurgery
Yoshinori Hashimoto, Takanori Fukuta, Hiromi Omura, Takayuki Tanaka
Although the life expectancy if patients with essential thrombocythemia (ET) is considered to be almost similar to that of the general population, advanced age, leukocytosis, and a previous history of thrombosis are poor prognostic factors, and it is important to prevent thrombohemorrhagic events, leukemic transformation, and secondary malignancies. We report an 85-year-old ET patient with a history of asymptomatic lacunar infarction, who developed symptomatic cerebral infarction and even chronic subdural hematoma...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Victor M Lu, Kevin Phan
No abstract text is available yet for this article.
March 2018: World Neurosurgery
Alexis Rafael Narvaez-Rojas, Luis Rafael Moscote-Salazar, Alfonso Pacheco-Hernandez
No abstract text is available yet for this article.
March 2018: World Neurosurgery
Abdullah Bin Zahid, David Balser, Rebekah Thomas, Margaret Y Mahan, Molly E Hubbard, Uzma Samadani
OBJECTIVE Chronic subdural hematoma (cSDH) is a highly morbid condition associated with brain atrophy in the elderly. It has a reported 30% 1-year mortality rate. Approximately half of afflicted individuals report either no or relatively unremarkable trauma preceding their diagnosis, raising the possibility that cSDH is a manifestation of degenerative or inflammatory disease rather than trauma. The purpose of this study was to compare the rates of cerebral atrophy before and after cSDH to determine whether it is more likely that cSDH causes atrophy or that atrophy causes cSDH...
March 2, 2018: Journal of Neurosurgery
Yuichi Mochizuki, Tomonori Kobayashi, Akitsugu Kawashima, Takayuki Funatsu, Takakazu Kawamata
Background: Chronic subdural hematoma (CSDH) of the posterior fossa is uncommon in adults. Only a few cases have been reported, and most of these were secondary to head injury or anticoagulant therapy. We herein describe a case of successful surgical treatment of CSDH in the posterior fossa after surgical removal of a large supratentorial and infratentorial dermoid cyst. Case Description: A 71-year-old woman underwent removal of a left supratentorial and infratentorial dermoid cyst via a left transzygomatic approach...
2018: Surgical Neurology International
Oktay Gurcan, Ahmet Gurhan Gurcay, Atilla Kazanci, Tuncer Goker, Oguzhan Eylen, Omer Faruk Turkoglu
The Fahr syndrome (FS) is a rare degenerative neurological disorder (its prevalence is <0.5%). FS is distinguished by the presence of abnormal bilateral intracranial calcifications with a predilection for the basal ganglia, also presented by movement disorders such as parkinsonism, paresis, and speech disorders. Chronic subdural hematoma (CSH), which is typically the result of mild head trauma, is a regularly encountered condition in elderly. A 63-year-old man has referred to our clinic from another hospital with a history of mild head trauma approximately a month ago...
January 2018: Asian Journal of Neurosurgery
Ziya Asan
OBJECTIVE: Discussion of the prognoses of subdural hematoma (SDH) patients who were not operated at the time of the first diagnosis and the etiological causes for the patients who experienced enlarged hematomas during the follow-up period. MATERIALS AND METHODS: The records, service files and radiological examinations of the patients diagnosed with SDH were reviewed. SDH patients were recorded under 5 different categories which can be listed as; acute SDH (ASDH), subacute SDH (SSDH), chronic SDH (CSDH), acute component with chronic SDH (A-CSDH) and subacute component with chronic SDH (S-CSDH)...
February 24, 2018: World Neurosurgery
Daisuke Ichinose, Satoru Tochigi, Toshihide Tanaka, Tomoya Suzuki, Jun Takei, Keisuke Hatano, Ikki Kajiwara, Fumiaki Maruyama, Hiroki Sakamoto, Yuzuru Hasegawa, Satoshi Tani, Yuichi Murayama
A 40-year-old man presented with a severe headache, lower back pain, and lower abdominal pain 1 month after a head injury caused by falling. Computed tomography (CT) of the head demonstrated bilateral chronic subdural hematoma (CSDH) with a significant amount in the left frontoparietal region. At the same time, magnetic resonance imaging (MRI) of the lumbar spine also revealed CSDH from L2 to S1 level. A simple drainage for the intracranial CSDH on the left side was performed. Postoperatively, the headache was improved; however, the lower back and abdominal pain persisted...
February 23, 2018: Neurologia Medico-chirurgica
Jiri Bartek, Kristin Sjåvik, Samuel Schaible, Sasha Gulati, Ole Solheim, Petter Förander, Asgeir Store Jakola
OBJECTIVE: To investigate the role of angiotensin converting enzyme (ACE) inhibitors in recurrence of chronic subdural hematoma (cSDH) after burr-hole surgery. MATERIALS AND METHODS: A retrospective review was conducted in a Scandinavian multicenter population-based cohort of 1252 adult cSDH patients operated with burr-hole surgery between January 1, 2005 and December 31, 2010. The risk of cSDH recurrence was assessed in users of ACE inhibitors, users of angiotensin II receptor blockers (ARB) and those without ACE inhibitor treatment (no ACE inhibitor group) using univariable and multivariable regression analyses...
February 22, 2018: World Neurosurgery
Eijiro Echizen, Kei Miyata, Ken Yamashita, Takeshi Mikami, Eichi Narimatsu, Nobuhiro Mikuni
BACKGROUND: Neurosurgical intervention for a patient with an extensive scalp burn is rare, but it might be associated with the high risk of surgical site infection. CASE DESCRIPTION: An 80-year-old man had a severe and extensive scalp burn. A chronic subdural hematoma (CSDH) was observed on a head CT for the assessment of bacteremia during treatment in the intensive care unit. To evaluate whether the CSDH might underlie his prolonged fever and sepsis pathology, we urgently evacuated the hematoma using one burr hole...
February 13, 2018: World Neurosurgery
Sho Umegaki, Shin-Ichiro Osawa, Kensuke Kimura, Toshimi Okushima, Nobuhisa Yajima, Tsuyoshi Kawamura, Teiji Tominaga
We report a patient with hypertrophic pachymeningitis and symptomatic stenosis of the superior sagittal sinus. A 71-year-old man presented with right hemiparesis, sensory-dominant aphasia, and right hemispatial neglect that had been worsening over 2 weeks. Computed tomography showed isodense crescent-shaped lesions deforming the surface of the left cerebral hemisphere, mimicking a subdural hematoma with atypical perifocal edema in the left parietal lobe. Magnetic resonance imaging showed diffuse thickening of the dura mater with contrast enhancement of his left cerebral hemisphere...
February 2018: No Shinkei Geka. Neurological Surgery
Kosuke Katayama, Naoya Matsuda, Kiyohide Kakuta, Masato Naraoka, Atsuhito Takemura, Seiko Hasegawa, Kenichi Akasaka, Norihito Shimamura, Katsuhiro Itoh, Kenichiro Asano, Konno Hiromu, Hiroki Ohkuma
The relatively high rate of postoperative recurrence in the treatment of chronic subdural hematoma (CSDH) is a significant problem. Goreisan is an herbal medicine that exhibits a hydragogue effect by inhibiting the expression of aquaporins, and its efficacy in preventing postoperative CSDH recurrence has been suggested by several case trials. This multicenter, prospective, randomized controlled trial was performed to investigate the preventative effect of goreisan on postoperative CSDH recurrence. Patients with symptomatic CSDH over 60 years old undergoing burr hole surgery were enrolled in this study...
February 14, 2018: Journal of Neurotrauma
Kavelin Rumalla, Vijay Letchuman, Kyle A Smith, Paul M Arnold
BACKGROUND: Hydrocephalus is a life-threatening sequela of traumatic brain injury (TBI) with poorly defined epidemiology in children. Here, we report the national incidence, risk factors, and outcomes associated with post-traumatic hydrocephalus (PTH). METHODS: The Kids Inpatient Database (2003, 2006, 2009, 2012) was queried using the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes to identify all patients (age 0 to 20) with TBI (850...
December 11, 2017: Pediatric Neurology
Haydn Hoffman, Robert Ziechmann, Timothy Beutler, Brendon Verhave, Lawrence S Chin
Chronic subdural hematoma (cSDH) is a common condition that disproportionately affects older patients. Given the greater risks of general anesthesia in this population, interest has turned towards less invasive surgical approaches such as the subdural evacuating port system (SEPS; Medtronic, Inc., Minneapolis, MN). There is a relative dearth of information about the outcomes following this procedure. Here, we present our institution's experience with SEPS and analyze factors associated with the outcomes. Using a prospectively maintained institutional database, we retrospectively identified all patients who presented with cSDH and received first line therapy with SEPS...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Vikram Mehta, Stephen C Harward, Eric W Sankey, Gautam Nayar, Patrick J Codd
Chronic subdural hematomas are encapsulated blood collections within the dural border cells with characteristic outer "neomembranes". Affected patients are more often male and typically above the age of 70. Imaging shows crescentic layering of fluid in the subdural space on a non-contrast computed tomography (CT) scan, best appreciated on sagittal or coronal reformats. Initial medical management involves reversing anticoagulant/antiplatelet therapies, and often initiation of anti-epileptic drugs (AEDs). Operative interventions, such as twist-drill craniostomy (TDC), burr-hole craniostomy (BHC), and craniotomy are indicated if imaging implies compression (maximum fluid collection thickness >1 cm) or the patient is symptomatic...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Chao-Guo You, Xue-Sheng Zheng
OBJECTIVES: Pneumocephalus is a common operative complication of chronic subdural hematoma. This study is to analyze the relationship between postoperative pneumocephalus and the recurrence and surgical outcomes. PATIENTS AND METHODS: This is a retrospective case-cohort study, including a pneumocephalus group (n = 46) and a control group (n = 181). Their recurrence rates, CT attenuation values, hospital stay, healing time and the neurological status were recorded and analyzed...
January 29, 2018: Clinical Neurology and Neurosurgery
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