scholarly journals P.082 Traumatic inter hemispheric subdural hematomas – clinical presentation, management and outcome

2016 ◽  
Vol 43 (S2) ◽  
pp. S39-S40
Author(s):  
R Bokari ◽  
S Schur ◽  
C Couturier ◽  
A Al-Azri ◽  
J Marcoux ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Conservative Management ◽  
Subdural Hematoma ◽  
Trauma Center ◽  
Complete Resolution ◽  
Clinical Presentation ◽  
Acute Subdural Hematoma ◽  
Detailed Review ◽  
Subdural Hematomas ◽  
Level I

Background: There is currently little data on the incidence, clinical outcome and management of traumatic interhemispheric subdural hematomas (IHSDHs). Methods: All patients admitted with an acute subdural hematoma (SDH) over a 5-year period at a Level I trauma center were included. A detailed review of all cases of large IHSDH (≥7 mm) was performed to document clinical presentation, management and outcomes. Results: Of 1182 patients with acute subdural hematomas (SDHs), 420 had IHSDHs (24%), and 50 were large IHSDHs. For patients with large IHSDH, the average age was 76 years (±11) and 44% were female. The average GCS was 12 on presentation (±4), and the average GOSE was 4 (±2). 66% of patients had associated cranial/ intracranial injuries (fracture, subarachnoid/epidural/SDH) and 26% required operations for acute convexity SDH. Three patients required operations for their IHSDH by inter hemispheric approach. By 10 weeks, 82% had a complete resolution of the IHSDHs. Conclusions: IHSDHs are often referred to as rare entities. Our results show they are common. Conservative management is often appropriate to manage even large IHSDHs, as most resolve spontaneously. This study will help document the occurrence of falx syndrome, as well as the management and outcomes of larger IHSDHs.

Acute subdural hematoma

1982 ◽  
Vol 57 (2) ◽  
pp. 254-257 ◽  
Author(s):  
Henry A. Shenkin
Keyword(s):  
Computerized Tomography ◽  
Subdural Hematoma ◽  
Neurological Status ◽  
Neurological Dysfunction ◽  
Acute Subdural Hematoma ◽  
Consecutive Series ◽  
Content Type ◽  
Subdural Hematomas ◽  
Fine Print

✓ In a consecutive series of 39 cases of acute subdural hematoma (SDH), encountered since computerized tomography diagnosis became available, 61.5% were found to be the result of bleeding from a small cortical artery, 25.6% were of venous origin, 7.7% resulted from cerebral contusions, and 5% were acute bleeds into chronic subdural hematomas. Craniotomy was performed promptly on admission, but there was no difference in survival (overall 51.3%) between patients with arterial and venous bleeds. The only apparent factor affecting survival in this series was the preoperative neurological status: 67% of patients who were decerebrate and had fixed pupils prior to operation died. Of patients with less severe neurological dysfunction, only 20% failed to survive.

scholarly journals Spontaneous resolution of large non-traumatic bilateral acute-on-chronic subdural hematoma

2017 ◽  
Vol 31 (1) ◽  
pp. 8-16
Author(s):  
D. Adam ◽  
D. Iftimie ◽  
Gina Burduşa ◽  
Cristiana Moisescu
Keyword(s):  
Conservative Treatment ◽  
Subdural Hematoma ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Neurological Status ◽  
Spontaneous Resolution ◽  
Subdural Hematomas ◽  
Gcs Score

Abstract Background and importance: Chronic subdural hematomas are a frequently encountered neurosurgical pathology, especially in the elderly. They often require surgical evacuation, but recent studies have shown good results with conservative treatment in selected cases. Clinical presentation: We report the case of a 72-year old patient that developed large, non-traumatic, bilateral, acute-on-chronic subdural hematoma after repeated abdominal surgery for appendicular carcinoma. He presented an abdominal wound infection and good neurological status (GCS score of 14 points), factors that indicated the delay of surgical intervention. Subsequent clinical and radiological improvement forestalled the operation altogether and he presented complete spontaneous resolution of subdural hematomas at only 5 months after diagnosis. Conclusion: Although surgical treatment is performed in the majority of chronic subdural hematomas, in clinically and radiologically selected cases, the operation can be avoided. The hematoma can present resolution, either spontaneously or with the help of conservative treatment.

Acute Subdural Hematoma

Neurotrauma ◽  
2019 ◽  
pp. 17-26
Author(s):  
Benjamin McGahan ◽  
Nathaniel Toop ◽  
Varun Shah ◽  
John McGregor
Keyword(s):  
Brain Injury ◽  
Arteriovenous Malformation ◽  
Conservative Management ◽  
Epidural Hematoma ◽  
Mass Effect ◽  
Acute Subdural Hematoma ◽  
Subdural Space ◽  
Cortical Injury ◽  
Subdural Hematomas ◽  
Hemorrhagic Lesion

Acute subdural hematomas are collections of acute blood in the subdural space. They usually present as a result of significant head trauma. They can occur spontaneously in relationship to an underlying hemorrhagic lesion such as tumor, arteriovenous malformation, or aneurysm. They are more likely to be associated with cortical injury than the epidural hematoma. Neurological symptoms on presentation are related to the underlying brain injury and/or mass effect. Acute subdural blood on CT scan is hyperdense, in a crescent shape, along the inner dural surface. Emergent surgical intervention via craniotomy is indicated in patients with at least 10 mm in thickness or at least 5 mm shift, or elevated ICP, or pupillary dilatations suggesting herniation, or progression of deficit based on the Glasgow Coma Score. Conservative management of small acute subdural hematomas may be done in select situations that include proper ICU monitoring for ICP elevations and neurological deteriorations.

Spontaneous resolution of traumatic acute subdural hematoma with good clinical outcome: A report of two cases

2014 ◽  
Vol 11 (2) ◽  
pp. 146-149
Author(s):  
Vinay Byrappa ◽  
Sonia Bansal ◽  
Sriganesh Kamath ◽  
Gopala Krishna N. Kadarapura
Keyword(s):  
Clinical Outcome ◽  
Subdural Hematoma ◽  
Spontaneous Resolution ◽  
Acute Subdural Hematoma ◽  
Good Clinical Outcome

Acute Subdural Hematoma: Direct Admission to a Trauma Center Yields Improved Results

1986 ◽  
Vol 26 (5) ◽  
pp. 445-450 ◽  
Author(s):  
JAMES L. STONE ◽  
ROBERT J. LOWE ◽  
OLGA JONASSON ◽  
ROBERT J. BAKER ◽  
JOHN BARRETT ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Trauma Center ◽  
Acute Subdural Hematoma ◽  
Direct Admission

scholarly journals Comparison of Clinical Outcome between Craniectomy and Craniotomy as Surgical Management of Traumatic Acute Subdural Hematoma: A Systematic Review and Meta-analysis

2020 ◽  
Vol 8 (F) ◽  
pp. 137-142
Author(s):  
Tjokorda Gde Bagus Mahadewa ◽  
Putu Eka Mardhika ◽  
Sri Maliawan ◽  
Nyoman Golden ◽  
Steven Awyono ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcome ◽  
Subdural Hematoma ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Surgical Techniques ◽  
Open Access Journal ◽  
Acute Subdural Hematoma ◽  
Poor Outcomes

BACKGROUND: Acute subdural hematoma (ASDH) is a major problem in traumatic brain injury. Surgical techniques for treating ASDH are varied, including cranioplastic craniotomy and large decompressive craniectomy. The superiority of craniectomy and craniotomy for treating ASDH is still controversial. AIM: The aim of this study was to compare the clinical outcome between craniectomy and craniotomy for treating traumatic ASDH through systematic review and meta-analysis. METHODS: This study used electronic articles published in PubMed, EBSCO, Google Scholar, and Directory of Open Access Journal. Articles included were full-text observational studies in Indonesian or English. Clinical outcome using the Glasgow Outcome Scale was compared between craniectomy and craniotomy. Statistical analysis was done using Review Manager 5.3. RESULTS: Six articles met our inclusion and exclusion criteria. We performed random effect model analysis because of high heterogeneity between studies (I2 = 77%; X2 = 21.98). The pooled risk ratio between craniectomy and craniotomy on poor outcomes was 1.41 (p = 0.02; 95% CI: 1.06–1.88). CONCLUSION: Craniectomy increases the risk of poor clinical outcomes in treating a traumatic ASDH.

scholarly journals The impact of age, gender, acuteness and etiology on short-term clinical outcome in patients with subdural hematomas - international dual-center study

2018 ◽  
Vol 146 (9-10) ◽  
pp. 538-542
Author(s):  
Ivo Kehayov ◽  
Aleksandar Kostic ◽  
Borislav Kitov ◽  
Vesna Nikolov ◽  
Hristo Zhelyazkov ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Outcome ◽  
Logistic Regression Analysis ◽  
Predictive Factors ◽  
Subdural Hematoma ◽  
Short Term ◽  
Subdural Hematomas ◽  
The Impact ◽  
Positive Effect

Introduction/Objective. Subdural hematoma is one of the most common intracranial types of bleeding with high risk of disability and mortality. The aim of this study was to determine the influence of age, sex, acuteness, and etiology of subdural hematoma on short-term clinical outcome in these patients. Methods. We retrospectively studied 288 patients who were diagnosed and operated on for subdural hematomas (SDH) with different etiology (traumatic and spontaneous) and acuteness (acute, subacute, and chronic) for a period of five years. Patients scored ? 5 points on the Glasgow Coma Scale at hospital admission were not included in this study. Clinical outcome was assessed by the modified Rankin Scale (mRS) score at hospital discharge. Descriptive statistics and logistic regression analysis were used to determine the effect of the investigated factors on short-term clinical outcome. Results. Logistic regression analysis was conducted to predict degree of recovery (good = mRS ?1 vs. poor = mRS ? 2 or death) using sex, age, acuteness, and etiology of SDH as predictive factors. It was established that the following three factors made a significant contribution to the outcome: age (p = 0.004), acuteness (p < 0.001), and etiology of a hematoma (p = 0.023), with acuteness being the strongest predictive factor. Sex was not a significant predictor, while age under 70 years and spontaneous origin of SDH were associated with lower mRS scores and had a positive effect on recovery chances. Conclusion. Age, acuteness, and etiology of hematoma are important predictive factors that influence the short-term clinical outcome in patients with SDH. These parameters should be taken into account when giving prognosis for recovery chances to a patient?s family and relatives.

Heterogeneity of acute subdural collections: In search of a unifying feature

Trauma ◽  
2020 ◽  
pp. 146040862094762
Author(s):  
Lindsay Duy ◽  
Arwa Badeeb ◽  
Walter Duy ◽  
Eman Alqahtani ◽  
Walter Champion ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Subdural Hematoma ◽  
Ct Scans ◽  
Acute Subdural Hematoma ◽  
Close Inspection ◽  
Subdural Hematomas ◽  
Contrast Ct

Introduction A variety of different acute subdural hematoma patterns of density have been reported in the literature and are commonly seen in clinical practice, including rare hypodense acute subdural hematomas. It is unclear if these acute hypodense collections are entirely hypodense or if on close inspection, they can reveal subtle, tiny hyperdense components. The purpose of this study was to determine if all acute subdural hemtomas contain a hyperdense component, including seemingly entirely hypodense subdural collections. Methods Non-contrast CT scans of 111 patients containing 320 hyperacute or acute subdural collections were analyzed for the presence of a hyperdense component. Hounsfield measurements were recorded. Results All hyperacute and acute subdural hematomas in our study had a hyperdense component. Hyperacute subdural hematomas have a hyperdense component >97.5% of the time (95% confidence), and acute subdural hematomas have a hyperdense component >99% of the time (95% confidence). Conclusion Lack of a hyperdense component in a subdural hematoma makes acute or hyperacute hematoma highly unlikely, and alternative diagnoses should be considered.

Risk Factors for Urinary Tract Infection or Pneumonia After Admission for Traumatic Subdural Hematoma at a Level I Trauma Center: Large Single-Institution Series

2020 ◽  
Vol 134 ◽  
pp. e754-e760
Author(s):  
Tammy B. Pham ◽  
Shanmukha Srinivas ◽  
Joel R. Martin ◽  
Michael G. Brandel ◽  
Arvin R. Wali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Subdural Hematoma ◽  
Trauma Center ◽  
Single Institution ◽  
Level I
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