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chronic subdural hematomas

Takahide Haku, Yasushi Motoyama, Yoshiaki Takamura, Shuichi Yamada, Ichiro Nakagawa, Young-Su Park, Hiroyuki Nakase
BACKGROUND: Chronic subdural hematoma (CSDH) often occurs in association with cerebrospinal fluid (CSF) hypovolemia. Many cases with CSDH due to CSF hypovolemia and treated by burr-hole surgery have been reported to present with paradoxical deterioration. However, the mechanisms and pathology of deterioration after surgery for CSDH due to CSF hypovolemia remain obscure. CASE DESCRIPTION: We report herein a 62-year-old man with gait disturbance due to subdural fluid collection (SDFC) who underwent burr-hole irrigation and additional craniotomy, in which postoperative deterioration resulted from rapidly progressing central herniation with large amount of air accumulation...
June 18, 2018: World Neurosurgery
Rongrui Tang, Jiantao Shi, Xuegang Li, Yongjie Zou, Long Wang, Yujie Chen, Rubin Yan, Boyuan Gao, Hua Feng
OBJECTIVE: To investigate the effects of atorvastatin on the surgical treatment of patients with chronic subdural hematoma (CSDH). METHODS: Our retrospective study included 245 consecutive adult patients undergoing burr hole craniotomy of CSDH. Data included baseline characteristics and recurrence, postoperative complications, and mortality. A univariate and multivariate regression model analyzed the association between administration of atorvastatin perioperatively and recurrence rates...
June 16, 2018: World Neurosurgery
Robert Ecker
No abstract text is available yet for this article.
June 13, 2018: World Neurosurgery
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE Isolated subdural hematomas (iSDHs) are one of the most common intracranial hemorrhage (ICH) types in the population with mild traumatic brain injury (mTBI; Glasgow Coma Scale score 13-15), account for 66%-75% of all neurosurgical procedures, and have one of the highest neurosurgical intervention rates. The objective of this study was to examine how quantitative hemorrhage characteristics of iSDHs in patients with mTBI at admission are associated with subsequent neurosurgical intervention. METHODS This was a 3...
June 15, 2018: Journal of Neurosurgery
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE A paucity of studies have examined neurosurgical interventions in the mild traumatic brain injury (mTBI) population with intracranial hemorrhage (ICH). Furthermore, it is not understood how the dimensions of an ICH relate to the risk of a neurosurgical intervention. These limitations contribute to a lack of treatment guidelines. Isolated subdural hematomas (iSDHs) are the most prevalent ICH in mTBI, carry the highest neurosurgical intervention rate, and account for an overwhelming majority of all neurosurgical interventions...
June 15, 2018: Journal of Neurosurgery
Hiroyuki Toi, Yukihiko Fujii, Toru Iwama, Hiroyuki Kinouchi, Hiroyuki Nakase, Kazuhiko Nozaki, Hiroki Ohkuma, Hajime Ohta, Hideo Takeshima, Hironobu Tokumasu, Yuhei Yoshimoto, Masaaki Uno
BACKGROUND Over the decades, postoperative recurrence of chronic subdural hematoma (CSDH) has not been resolved. OBJECT The objective of our study was to investigate whether the recurrence rate of CSDH is decreased when artificial cerebrospinal fluid (ACF) is used as irrigation solution for CSDH surgery. METHODS The present study was a multi-center, prospective, randomized, open parallel group comparison test of patients enrolled from 10 hospitals in Japan. Eligible patients with CSDH were randomly assigned to undergo burr hole drainage with either normal saline (NS) or ACF irrigation...
June 14, 2018: Journal of Neurotrauma
Shinichiro Teramoto, Akira Tsunoda, Kaito Kawamura, Natsuki Sugiyama, Rikizo Saito, Chikashi Maruki
A 70-year-old man, who had previously undergone surgical resection of left parasagittal meningioma involving the middle third of the superior sagittal sinus (SSS) two times, presented with recurrence of the tumor. We performed removal of the tumor combined with SSS resection as Simpson grade II. After tumor removal, since a left dominant bilateral chronic subdural hematoma (CSDH) appeared, it was treated by burr hole surgery. However, because the CSDH rapidly and repeatedly recurred and eventually changed to acute subdural hematoma, elimination of the hematoma with craniotomy was accomplished...
April 2018: Surgery Journal
Wolf-Dirk Niesen, Michael Rosenkranz, Cornelius Weiller
Introduction: Transcranial high-resolution ultrasonography reliably allows diagnosis and monitoring of intracerebral hemorrhage in adults. Sonographic monitoring of subdural hematoma (SDH) has not been evaluated in adults so far. This study investigates the reliability of transcranial gray-scale sonography (TGS) in monitoring acute and chronic SDH in adults. Methods: TGS was performed in 47 consecutive patients with either acute or chronic SDH confirmed by cerebral CT...
2018: Frontiers in Neurology
Takayuki Anno, Nobuyuki Kobayashi
Objective: Both infected subdural hematoma (ISH) and Edwardsiella tarda infections are rare in humans. E. tarda is a motile, facultative anaerobic, gram-negative rod bacterium, which is isolated from fresh or brackish water, but not usually from humans. Extra-intestinal E. tarda infections are rare and might cause severe clinical symptoms. However, ISH caused by E. tarda has not been reported previously. We report the first case of ISH due to E. tarda . Patient: A 76-year-old man was admitted to our hospital with a headache, loss of appetite, and nausea...
May 2018: Journal of Rural Medicine: JRM
Alfonso López, Shawn McKenna
An 8-y-old lactating Holstein cow was presented to the herd veterinarian with a history of acute ataxia, and because of poor prognosis, the animal was euthanized and submitted for postmortem examination. A lumbar vertebra was incompletely fractured and had an adjacent subdural hematoma. The pancreas had a hard texture with exaggerated nodular appearance, and on cut surface, the pancreatic ducts appeared fibrotic and contained scores of round-to-faceted pancreatoliths of 0.5-2.0 mm diameter. These calculi extended from the major ducts to the pancreatic duct, sphincter, and into the duodenal lumen...
June 1, 2018: Journal of Veterinary Diagnostic Investigation
Tomotaka Shiraishi, Renpei Sengoku, Shigehiko Takanashi, Mari Shibukawa, Kazutomi Kanemaru, Shigeo Murayama
An 86-year-old woman presented with generalized chorea in the face and extremities, which gradually progressed for two weeks. Cranial CT revealed a chronic subdural hematoma (CSDH) that covered the left parietal lobe. Discontinuation of amantadine did not improve the chorea. The hematoma was evacuated and the chorea completely subsided in a week. The pathogenesis leading to chorea in CSDH remains unclear. A unilateral hematoma presenting with generalized chorea similar to the present patient and two others with unilateral CSDH causing ipsilateral hemichorea have been reported...
June 1, 2018: Rinshō Shinkeigaku, Clinical Neurology
Yuichi Hayashi, Hiroshi Fujioka
No abstract text is available yet for this article.
May 2018: No Shinkei Geka. Neurological Surgery
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...
July 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
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