scholarly journals Chronic subdural hematoma - diagnosis, treatment and perspectives

2020 ◽  
Vol 73 (9-10) ◽  
pp. 295-300
Author(s):  
Mirela Jukovic ◽  
Viktor Till

Introduction. Chronic subdural hematoma has become an important entity in radiological, neurological and neurosurgery practice. Classification. The classification of chronic subdural hematoma is most often done in relation to the time of the disease onset (acute, subacute and chronic), whereas the second classification is based on hematoma density using computed tomography. Clinical presentation. The clinical presentation may mimic a spectrum of various diseases and chronic subdural hematoma can be easily overlooked without radiological verification. Diagnosis. The diagnosis of chronic subdural hematoma is partly clinical and partly radiological. In most cases, computed tomography is the initial diagnostic method for detection of this disease. Many studies point to different management strategies in the diagnosis and treatment of the disease. Therapy. The therapy of chronic subdural hematoma depends on the patient?s neurological deficit, but generally it is divided into conservative and surgical treatment. Conclusion. The aim of this paper is to review chronic subdural hematomas with reference to their clinical and radiological characteristics for better understanding of these phenomena.

2002 ◽  
Vol 42 (2) ◽  
pp. 53-56 ◽  
Author(s):  
Yutaka HIRASHIMA ◽  
Naoya KUWAYAMA ◽  
Hideo HAMADA ◽  
Nakamasa HAYASHI ◽  
Shunro ENDO

2017 ◽  
Vol 31 (1) ◽  
pp. 8-16
Author(s):  
D. Adam ◽  
D. Iftimie ◽  
Gina Burduşa ◽  
Cristiana Moisescu

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.


2021 ◽  
Author(s):  
Gabriela Ferreira Kalkmann ◽  
Carlos Umberto Pereira ◽  
Francisco de Assis Pereira ◽  
Débora Moura da Paixão Oliveira ◽  
Nicollas Nunes Rabelo

Introduction: The clinical manifestations of chronic subdural hematoma (CSDH) are often confused with other medical entities in the elderly, making their early diagnosis difficult or difficult. Early diagnosis is important, since its prognosis is directly associated with the preoperative neurological state, thus resulting in a worse vital and functional prognosis. Objectives: Report through a literature review the clinical manifestations of CSDH in the elderly population. Methods: Literature review, with the search terms: “Signs and Symptoms”, “Chronic Subdural Hematoma”, Aged, Diagnosis and Prognosis. In which PubMed, Lilacs, Scielo, Cochrane and TripDataBase data platforms were used. The inclusion criteria were: original studies published in any language. Articles in which full reading was prevented were excluded. With the application of the inclusion and exclusion criteria, 110 articles were included in the study. Results: Clinical presentation depends on the location, volume of the hematoma, rapid growth, the location of the CSDH, whether unilateral or bilateral, and the clinical conditions of the patient. Because the forms of clinical presentation of CSDH are variable, it is necessary that health professionals linked to the elderly (geriatrician, psychiatrist, general practitioner) have knowledge of this clinical entity. Conclusions: The recognition of classic forms as well as the identification of risk factors in the elderly favors the timely diagnosis and treatment of CSDH in the elderly population.


2019 ◽  
Vol 11 (1) ◽  
pp. 87-93
Author(s):  
Takuro Inoue ◽  
Hisao Hirai ◽  
Ayako Shima ◽  
Fumio Suzuki ◽  
Masayuki Matsuda

Chronic subdural hematoma (CSH) in the posterior fossa is extremely rare. The surgical strategy is still controversial. We report a case of bilateral CSH in the posterior fossa successfully treated with a single-burr hole surgery. A 74-year-old man under anticoagulation and antiplatelet therapy developed headache and nausea during observation for an asymptomatic supratentorial CSH. Radiological examinations revealed appearance of bilateral CSH in the posterior fossa associated with hydrocephalus. Upon rapid deterioration of the patient’s consciousness, an urgent treatment was required. A burr hole was made near the transverse-sigmoid junction on the left side to access the hematoma. No ventricular drainage was placed as his consciousness improved during the decompression of the hematoma. Postoperative computed tomography showed that bilateral CSH and hydrocephalus had been successfully treated. In bilateral CSH in the posterior fossa, there may be a connection between each side. CSH in the posterior fossa, when urgent, can be treated under local anesthesia with a unilateral burr hole irrigation.


2018 ◽  
Vol 15 (3) ◽  
pp. 32-38
Author(s):  
Nikunja Yogi ◽  
Pankaj Raj Nepal ◽  
Dinesh Nath Gongal ◽  
Upendra Prasad Devkota

Recurrences after evacuation of chronic subdural hematoma are seen in 2-33% of cases with various surgical approaches. Various demographical, clinical, radiological, surgical and postoperative management strategies have been explored as the possible predictors of recurrence. We performed a retrospective analysis in 160 patients with chronic subdural hematoma with an aim to analyze the post-operative recurrences and factors associated with it. Various socio demographic and clinico-radiological parameters were studied against the rate of recurrence after surgery using Chi square/Fischer Exact Test. Factors showing significant association on univarate analysis were then analysed using binary logistic regression. The rate of recurrence of CSDH in our study was 5% and the mean duration of recurrence was 33 days. Chronic alcohol use (p=0.007) and intraoperative brain expansion ((p=0.001) were the two factors associated with recurrence of CSDH. On binary logistic regression chronic alcohol use (wald-6.467, p=0.011) and intraoperative brain expansion (wald=6.674, p=0.010) were both associated significantly with recurrence of CSDGH with an odds of 7.804 and 0.058 respectively.


2013 ◽  
Vol 53 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Masahiko TOSAKA ◽  
Kazuya SAKAMOTO ◽  
Saiko WATANABE ◽  
Masahiko YODONAWA ◽  
Hideo KUNIMINE ◽  
...  

1977 ◽  
Vol 1 (2) ◽  
pp. 262
Author(s):  
K. Komatsu ◽  
M. Matsunaga ◽  
K. Tanaka ◽  
R. Yoshida ◽  
M. Ohata ◽  
...  

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