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chronic subdural hemorrhage

Yukinori Akiyama, Izumi Koyanagi, Nobuhiro Mikuni
BACKGROUND: Spinal subdural hematoma is a rare clinical entity marked by the onset of pain and paralysis, which is usually associated with hemorrhagic disorders, trauma, and iatrogenic causes such as lumbar puncture or epidural anesthesia. CASE PRESENTATION: A 71-year-old male was admitted to our hospital with 2 weeks' history of bilateral lower leg pain, dysesthesia, paraparesis, and urinary disturbance. Magnetic resonance imaging revealed characteristic findings at the thoracolumbar spine, and surgical evacuation successfully treated this condition...
December 3, 2016: World Neurosurgery
Jun Hyong Ahn, Hyo Sub Jun, Ji Hee Kim, Jae Keun Oh, Joon Ho Song, In Bok Chang
OBJECTIVE: Although a high incidence of chronic subdural hematoma (CSDH) following traumatic subdural hygroma (SDG) has been reported, no study has evaluated risk factors for the development of CSDH. Therefore, we analyzed the risk factors contributing to formation of CSDH in patients with traumatic SDG. METHODS: We retrospectively reviewed patients admitted to Hallym University Hospital with traumatic head injury from January 2004 through December 2013. A total of 45 patients with these injuries in which traumatic SDG developed during the follow-up period were analyzed...
November 2016: Journal of Korean Neurosurgical Society
Ajay Hegde, Rajesh Nair, Sunil Upadhyaya
BACKGROUND: Spontaneous Intracerebral hemorrhage is a rare and challenging condition to treat, especially in haemophiliacs. With their innate predilection to bleed following trivial trauma, surgical management of such cases have been individualised and no treatment protocols exist. Often they are managed with craniotomy and evacuation under cover of AHF. DISCUSSION: Here we discuss the nuances, clinical and treatment dilemma that one faces while treating a patient, diagnosed with haemophilia, with spontaneous subdural haematoma...
October 25, 2016: International Journal of Surgery Case Reports
Toshiyuki Amano, Kenta Takahara, Naoki Maehara, Takafumi Shimogawa, Nobutaka Mukae, Tetsuro Sayama, Shoji Arihiro, Shuji Arakawa, Takato Morioka, Sei Haga
OBJECTIVE: The use of antithrombotic agents such as anticoagulants and antiplatelet agents is widespread, and the opportunities to treat patients with chronic subdural hematoma (CSDH) under antithrombotic therapy are growing. However, whether antithrombotic therapy contributes to postoperative complications and recurrences of CSDH and how these agents should be managed in the surgical treatment of CSDH remains unclear. METHODS: We retrospectively analyzed 150 consecutive patients with CSDH who underwent neurosurgical interventions at Kyushu Rosai Hospital from 2011 to 2015 and followed them for more than 3 months...
October 7, 2016: Clinical Neurology and Neurosurgery
Chen L, Dong L, Wang Xd, Zhang Hz, Wei M, She L
A 72-year-old man with bilateral chronic subdural hematomas was admitted to our department and treated using a YL-1 type hematoma aspiration needle. The treatment was complicated by hemorrhage of the basal ganglia and brain stem. This patient had no history of hypertension. We evaluated the relevant literature to analyze the causes of cerebral hemorrhage in similar patients. This case report illustrates that the stability of the intracranial pressure should be closely monitored during the surgical treatment of chronic subdural hematomas, and large fluctuations in the cerebral perfusion pressure should be avoided during the operation...
October 1, 2016: World Neurosurgery
Megan M Letson, Jennifer N Cooper, Katherine J Deans, Philip V Scribano, Kathi L Makoroff, Kenneth W Feldman, Rachel P Berger
Infants with minor abusive injuries are at risk for more serious abusive injury, including abusive head trauma (AHT). Our study objective was to determine if children with AHT had prior opportunities to detect abuse and to describe the opportunities. All AHT cases from 7/1/2009 to 12/31/2011 at four tertiary care children's hospitals were included. A prior opportunity was defined as prior evaluation by either a medical or child protective services (CPS) professional when the symptoms and/or referral could be consistent with abuse but the diagnosis was not made and/or an alternate explanation was given and accepted...
October 2016: Child Abuse & Neglect
L Chen, L Dong, L She, H Z Zhang, X D Wang, Z C Yan, W Wu, L Yang
It is written to discuss the effect and syndromes of novel YL-1 hollow needle aspiration drainage system to treat chronic subdural hematoma. Collecting clinical data about 697 patients with chronic subdural hematoma in neurosurgery of People' Hospital in North Jiangsu from January 2004 to December 2014, including clinical manifestation, imaging data, operation time, postoperative complications and prognostic factors and so on. 593 patients got cured, 53 patients with recurrence, 19 patients with acute subdural hematoma, 13 patients with poor drainage, 9 case of patients with acute epidural hematoma, puncture failure in 6 cases, 3 cases of pulmonary infection, one got intracranial hemorrhage (brain stem and basal ganglia hemorrhage)...
September 20, 2016: Neurological Sciences
Lauren M Nentwich, Benjamin Grimmnitz
Neurologic diseases are a major cause of death and disability in elderly patients. Due to the physiologic changes and increased comorbidities that occur as people age, neurologic diseases are more common in geriatric patients and a major cause of death and disability in this population. This article discusses the elderly patient presenting to the emergency department with acute ischemic stroke, transient ischemic attack, intracerebral hemorrhage, subarachnoid hemorrhage, chronic subdural hematoma, traumatic brain injury, seizures, and central nervous system infections...
August 2016: Emergency Medicine Clinics of North America
Hua Liu, Zhengxiang Luo, Zhongkun Liu, Jian Yang, Shifeng Kan
OBJECTIVE: Chronic subdural hematoma (CSDH) is a common form of intracranial hemorrhage with a substantial recurrence rate. Atorvastatin may reduce CSDH via its anti-inflammatory and pro-angiogenesis effects, but its effectiveness for preventing recurrent CSDH has never been explored. We hypothesized that atorvastatin is effective in reducing recurrence of CSDH after surgery and identified determining factors predictive of hematoma recurrence. METHODS: A prospective study was conducted in 168 surgical cases of CSDH...
2016: Frontiers in Neuroscience
Andres M Alvarez-Pinzon, Alan A Stein, Jose E Valerio, Victor Delgado, Jennifer A Escalante, Nithia Lopez, Aizik L Wolf
UNLABELLED: OBJECTIVE : To describe a surgical technique and to report using a retrospective study the efficacy of peritoneal shunts for the treatment of recurrent/chronic subdural hematoma (CSDH). We describe the considerations, complications, and outcomes related to this technique. METHODS : In a retrospective cohort study, 125 charts with a diagnosis of subacute/chronic subdural hematoma were assigned for evaluation. Of the charts reviewed, 18 charts were found from subjects with a diagnosis of recurrent sub-acute or chronic subdural hematoma...
2016: Curēus
Gurneet Singh Sawhney, Cecil R Ross, Manmeet Singh Chhabra, Vineesh K Varghese, Ashish Tiwari, Ashis K Chand
Chronic subdural hematoma (SDH) is one of the leading causes of morbidity and mortality in elderly. Patients taking antiplatelets and/or anticoagulants have increased risk of bleeding during the perioperative period. Precise dose blood products and specific surgical technique have been effective in preventing hemorrhagic complications perioperatively. From Jan 2010 to Dec 2012, 25 patients who were on antiplatelets and/or oral anticoagulants underwent emergency surgery for chronic or acute on chronic SDH. Patients were divided into three groups: group I-patients on antiplatelets, group II-patients on oral anticoagulants, and group III-patients taking both...
April 2016: Indian Journal of Surgery
Junhak Kim, Jongun Moon, Tackeun Kim, Seongyeol Ahn, Gyojun Hwang, Jaeseung Bang, O-Ki Kwon, Chang Wan Oh
OBJECTIVE: Chronic subdural hematoma (CSDH) is a common form of extra axial hemorrhage in the elderly. A surgical procedures such as a burr hole trephination are used for the CSDH treatment. The recurrence rate of CSDH is reported to range from 2.3 to 33%. In the current study, we focused on the determination of risk factors associated with the recurrence of CSDH. METHODS: We retrospectively reviewed 368 consecutive patients with CSDH treated by burr hole trephination...
October 2015: Korean Journal of Neurotrauma
Claudia Stöllberger, Josef Finsterer
BACKGROUND: Apixaban, a factor-Xa-inhibitor, is one of the non-vitamin-K-antagonist oral anticoagulants (NOACs) which are increasingly used in atrial fibrillation (AF). In real life even patients with contraindications to vitamin K antagonists (VKAs) receive NOAC because NOAC are considered as "safer" than VKAs. CASE DESCRIPTION: In a 61-years-old man with hypertension, heart failure and paroxysmal AF apixaban was started. Despite advices from his physicians, he continued alcohol abuse and suffered from recurrent falls...
2016: Neurologia i Neurochirurgia Polska
Shigeta Fujitani, Osamu Ishikawa, Keisuke Miura, Yasuhiro Takeda, Haruo Goto, Keiichiro Maeda
OBJECTIVE Chronic subdural hematoma (CSDH) is a common form of intracranial hemorrhage with a recurrence rate of 9.2%-26.5% after bur hole surgery. Occasionally patients with bilateral CSDH undergo unilateral surgery because the contralateral hematoma is deemed to be asymptomatic, and in some of these patients the contralateral hematoma may subsequently enlarge, requiring additional surgery. The authors investigated the factors related to the growth of these hematomas. METHODS Ninety-three patients with bilateral CSDH who underwent unilateral bur hole surgery at Aizu Chuo Hospital were included in a retrospective analysis...
April 15, 2016: Journal of Neurosurgery
J A Cramer, U A Rassner, G L Hedlund
A possible misconception among radiologists is that chronic subdural hemorrhage should show some degree of blooming on T2*-gradient recalled-echo or susceptibility-weighted sequences such as SWI and susceptibility-weighted angiography, which is not necessarily true. We present 5 cases of chronic subdural hemorrhages in infants, demonstrating intensity near or greater than that of CSF with variable amounts of hemosiderin staining along the neomembranes. We review the physiology and MR imaging physics behind the appearance of a chronic subdural hemorrhage, highlighting that the absence of a BBB can allow hemosiderin to be completely removed from the subdural compartment...
September 2016: AJNR. American Journal of Neuroradiology
Atsushi Kobayashi, Goro Nagashima, Masayuki Noda, Akihito Kato, Hiroyuki Morishima, Junki Koike
Hemorrhage sometimes occurs within arachnoid cysts, however, organized arachnoid cysts has not been reported. We speculate the previous invasive stress or some kind of infection may have triggered the formation of the organized membrane, which may have formed via a similar mechanism to that for organized chronic subdural hematomas.
March 2016: Clinical Case Reports
Yuji Agawa, Yohei Mineharu, Shoichi Tani, Hidemitsu Adachi, Hirotoshi Imamura, Nobuyuki Sakai
Chronic subdural hematoma (CSDH) has been recognized as a benign disease, but its clinical outcome is not well documented. This study aims to expand the knowledge base regarding the outcome of CSDH. We retrospectively reviewed clinical characteristics of CSDH operated in the Kobe City Medical Center General Hospital between June 2005 and June 2012. Variants included age at onset, sex, laterality, presence of headache, consciousness level, and risk factors for hemorrhage such as malignancy or intake of anticoagulants...
2016: Neurologia Medico-chirurgica
Sriharsha Bokka, Adarsh Trivedi
BACKGROUND: A chronic subdural hematoma is an old clot of blood on the surface of the brain between dura and arachnoid membranes. These liquefied clots most often occur in patients aged 60 and older with brain atrophy. When the brain shrinks inside the skull over time, minor head trauma can cause tearing of blood vessels over the brain surface, resulting in a slow accumulation of blood over several days to weeks. AIM OF THE STUDY: To evaluate the role of membrane in hematoma evaluation and to correlate its histopathology with clinic-radiological aspects of the condition and overall prognosis of patients...
January 2016: Asian Journal of Neurosurgery
Kyeong-Seok Lee
Chronic subdural hematomas (CSHs) are generally regarded to be a traumatic lesion. It was regarded as a stroke in 17th century, an inflammatory disease in 19th century. From 20th century, it became a traumatic lesion. CSH frequently occur after a trauma, however, it cannot occur when there is no enough subdural space even after a severe head injury. CSH may occur without trauma, when there is sufficient subdural space. The author tried to investigate trends in the causation of CSH. By a review of literature, the author suggested a different view on the causation of CSH...
January 2016: Journal of Korean Neurosurgical Society
Rosario Maugeri, Antonella Giugno, Francesca Graziano, Massimiliano Visocchi, Cole Giller, Domenico Gerardo Iacopino
BACKGROUND: To demonstrate that the diagnosis of an intracranial subdural hematoma should be considered for patients presenting with acute or delayed symptoms of intracranial pathology following resection of a spinal tumor. CASE DESCRIPTION: We present a case of a 57-year-old woman found to have a chronic subdural hematoma 1 month following resection of a thoracic extramedullary ependymoma. Evacuation of the hematoma through a burr hole relieved the presenting symptoms and signs...
2016: Surgical Neurology International
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