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chronic subdural hematomas

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https://www.readbyqxmd.com/read/28411236/thromboembolism-prevention-after-chronic-subdural-hematoma-in-the-elderly-a-leap-in-the-dark
#1
EDITORIAL
Jose I Suarez, Gregory Kapinos
No abstract text is available yet for this article.
April 14, 2017: Neurology
https://www.readbyqxmd.com/read/28411235/anticoagulant-and-antiplatelet-use-in-seniors-with-chronic-subdural-hematoma-systematic-review
#2
Santhosh Nathan, Zahra Goodarzi, Nathalie Jette, Clare Gallagher, Jayna Holroyd-Leduc
OBJECTIVE: To address whether to restart older patients on anticoagulants or antiplatelet agents in the setting of a chronic subdural hematoma (cSDH). METHODS: This is an update of a previous review (searched until July 2012). Medline, EMBASE, ISI Web of Knowledge, Google Scholar, PLOS, and the Cochrane Register for Systematic Reviews databases were searched from January 2012 to December 2016. Studies included older adults (those over 65 years) experiencing traumatic subdural hematoma or cSDH who were on anticoagulation or antiplatelet agents...
April 14, 2017: Neurology
https://www.readbyqxmd.com/read/28389834/chronic-subdural-hematoma-in-the-oldest-old-population
#3
REVIEW
Miguel Gelabert-González, Paula Román-Pena, Eduardo Arán-Echabe
No abstract text is available yet for this article.
April 7, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28382656/surgery-for-chronic-subdural-hematoma-in-nonagenarians-a-scandinavian-population-based-multicenter-study
#4
J Bartek, K Sjåvik, F Ståhl, H Kristiansson, O Solheim, S Gulati, L M Sagberg, P Förander, A S Jakola
OBJECTIVE: Chronic subdural hematoma (cSDH) is a prevalent condition often seen in the elderly, with surgery being the treatment of choice when symptomatic. So far, few have explored the surgical outcomes in patients 90 years or older. The aim of this study was to investigate outcome after cSDH surgery in nonagenarians (≥90 y/o group) compared to younger adult patients (<90 y/o group). MATERIALS: In a Scandinavian population-based cohort we conducted a retrospective review of 1,254 patients undergoing primary burr-hole procedures for cSDH between January 1, 2005 and December 31, 2010 at three neurosurgical centers...
April 6, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28381926/subperiosteal-drainage-versus-subdural-drainage-in-the-management-of-chronic-subdural-hematoma-a-comparative-study
#5
Adrian Ng Wei Chih, Albert Wong Sii Hieng, Noor Azman A Rahman, Jafri Malin Abdullah
INTRODUCTION: Symptomatic chronic subdural hematomas (CSDH) remain one of the most frequent diagnoses in current neurosurgical practice. Burr-hole craniostomy with irrigation and placement of close-system drainage is the current recommended surgery for symptomatic CSDH. The aim of this study is to perform a direct comparison between two surgical techniques in the treatment of symptomatic CSDH, which have been proven in previous studies to be efficient. Our main objective was to compare the efficacy of placement of a subperiosteal drain (SPD) and a subdural drain (SDD) following single burr-hole craniostomy and irrigation, and to demonstrate any significant differences in terms of overall surgical complications, functional outcome at three months and mortality rate...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28379528/a-reliable-grading-system-for-prediction-of-chronic-subdural-hematoma-recurrence-requiring-reoperation-after-initial-burr-hole-surgery
#6
Milo Stanišic, Are Hugo Pripp
BACKGROUND: There is no widely adopted grading system for the prediction of postoperative recurrence requiring reoperation (RrR) in patients with chronic subdural hematoma (CSDH). OBJECTIVE: We developed a CSDH grading system to predict RrR based on predictive characteristics that can be objectively assessed at the time of first presentation and initial surgery. METHODS: Prospectively collected data from 107 consecutive surgical patients with CSDH were reviewed...
March 30, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28367945/a-case-of-superficial-siderosis-ameliorated-after-closure-of-dural-deficit-detected-by-mri-ciss-constructive-interference-in-steady-state-imaging
#7
Ayako Sakoda, Ken-Ichiro Yamashita, Mitsumasa Hayashida, Yukihide Iwamoto, Ryo Yamasaki, Jun-Ichi Kira
A 64-year-old male developed headache, dizziness, and difficulty hearing, two years after an operation for chronic subdural hematoma due to head injury. These symptoms gradually worsened over the following 15 years. As he showed bloody cerebrospinal fluid (CSF) and marginal hypointensity on the surface of the brain and spinal cord on T2/T2*-weighted MRI, he was diagnosed with superficial siderosis (SS), although the source of the bleeding was unclear and anti-hemorrhagic drugs were ineffective. When he was admitted to our hospital, neurological examination disclosed horizontal gaze-evoked nystagmus, severe bilateral hearing loss, scanning speech, and limb and truncal ataxia...
March 30, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28367840/the-effect-of-irrigation-solutions-on-recurrence-of-chronic-subdural-hematoma-a-consecutive-cohort-study-of-234-patients
#8
Masashi Kuwabara, Takashi Sadatomo, Kiyoshi Yuki, Keisuke Migita, Yasutaka Imada, Kiyoharu Shimizu, Takeshi Hara, Hideo Oba, Kaoru Kurisu
Chronic subdural hematomas (CSDHs) occur often in elderly persons and can occur with mild head trauma. With burr-hole irrigation as standard treatment, symptoms usually improve and can be cured, and outcomes are good, but postoperative recurrences are a common problem. This study investigated the effectiveness and recurrence rates when using artificial cerebrospinal fluid (ACF) instead of normal saline (NS) as an irrigation solution for burr-hole irrigation in patients with CSDH. This prospective study included 234 consecutive patients who underwent initial surgical treatment by burr-hole irrigation for a CSDH between April 2008 and June 2015...
March 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28362919/activation-of-nuclear-factor-kappa-b-in-endothelial-cells-of-chronic-subdural-hematoma-outer-membranes
#9
Koji Osuka, Yasuo Watanabe, Nobuteru Usuda, Masahiro Aoyama, Reo Kawaguchi, Mikinobu Takeuchi, Masakazu Takayasu
BACKGROUND: Chronic subdural hematoma (CSDH) is considered an angiogenic and inflammatory disease. Nuclear factor-kappa B (NF-κB) induces the production of inflammatory cytokines and adhesion molecules, which play an essential role in angiogenesis and inflammation. Recently, the double-stranded RNA-activated protein kinase (PKR) was shown to directly interact with NF-κB subunits to influence its transcriptional activity. OBJECTIVE: To examine the expression of NF-κB signaling pathway components and PKR in CSDH outer membranes...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28359924/prolonged-cerebral-hyperperfusion-and-subcortical-low-intensity-on-fluid-attenuated-inversion-recovery-images-unusual-manifestation-after-removal-of-organized-chronic-subdural-hematoma
#10
Satoru Tanioka, Yu Sato, Kazuhiko Tsuda, Shigehiko Niwa, Hidenori Suzuki
BACKGROUND: Cerebral hyperperfusion sometimes occurs after removal of chronic subdural hematoma (CSH) and usually resolves within a few days without any symptoms. Subcortical low intensity (SCLI) on fluid attenuated inversion recovery (FLAIR) magnetic resonance images is rare and has been reported in some diseases other than CSH. The authors describe a case of organized CSH who suffered prolonged neurologic deterioration, SCLI and cerebral hyperperfusion postoperatively. CASE DESCRIPTION: An 81-year-old man, presenting with left hemiparesis, underwent craniotomy for right organized CSH after 2-time burr-hole surgeries...
March 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28345124/evaluation-of-cortical-brain-parenchyma-by-diffusion-and-perfusion-mri-before-and-after-chronic-subdural-hematoma-surgery
#11
Bekir Akgun, Hakan Cakin, Sait Ozturk, Hanefi Yildirim, Izzet Okcesiz, Saim Kazan, Fatih Serhat Erol
AIM: To evaluate microcirculatory changes in neighboring parenchyma as a result of pressure due to chronic subdural hematoma (CSDH) in early and late periods after hematoma drainage. MATERIAL AND METHODS: The subjects comprised 25 patients who underwent CSDH drainage. Brain diffusion and perfusion MRIs were obtained preoperatively, 48 h (early period) and 2 months (late period) postoperatively. Measurements were performed on 1 cm2 regions of interest in the neighboring parenchymal tissue...
February 21, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28342701/predictive-subtle-or-overlooked-initial-head-ct-findings-in-patients-who-develop-delayed-chronic-subdural-hematoma
#12
William C Olivero, Huan Wang, Arash Farahvar, Thomas A Kim, Fei Wang
With the aging population, the incidence of chronic subdural hematoma (CSDH) is expected to rise. Once symptomatic the morbidity from CSDH is not insignificant. We studied patients who had a minor head injury and CT brain scan prior to developing CSDH to determine if there were any predictors on these scans for subsequent development of a CSDH. A retrospective review was performed on all patients operated for CSDH over a 3-year period and a review performed on those who had imaging studies at the time of a preceding minor head injury...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28325463/perioperative-management-of-anticoagulation
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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