scholarly journals Postoperative Chronic Subdural Hematoma Following Unruptured Intracranial Aneurysm Surgery: Prevention with Arachnoid Plasty and Conservative Management Using Gorei-san

2014 ◽  
Vol 42 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Keisuke TSUTSUMI ◽  
Yuki MATSUNAGA ◽  
Takashi FUJIMOTO ◽  
Ichiro KAWAHARA ◽  
Tomonori ONO ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Conservative Management ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Aneurysm Surgery ◽  
Unruptured Intracranial Aneurysm

scholarly journals Spinal Subdural Hematoma Following Intracranial Aneurysm Surgery

2007 ◽  
Vol 47 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Myoung Soo KIM ◽  
Chae Heuck LEE ◽  
Seung Jun LEE ◽  
Jong Joo RHEE
Keyword(s):  
Intracranial Aneurysm ◽  
Subdural Hematoma ◽  
Aneurysm Surgery ◽  
Spinal Subdural Hematoma

Uncommon presentation of ruptured intracranial aneurysm during surgical evacuation of chronic subdural hematoma: case report

2008 ◽  
Vol 69 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Roberto Stefini ◽  
Fabio Ghitti ◽  
Riccardo Bergomi ◽  
Emanuela Catenacci ◽  
Nicola Latronico ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Aneurysm ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Uncommon Presentation ◽  
Ruptured Intracranial Aneurysm ◽  
Surgical Evacuation

Predictors of 30-day perioperative morbidity and mortality of unruptured intracranial aneurysm surgery

2016 ◽  
Vol 149 ◽  
pp. 75-80 ◽  
Author(s):  
Panagiotis Kerezoudis ◽  
Brandon A. McCutcheon ◽  
Meghan Murphy ◽  
Tarek Rayan ◽  
Hannah Gilder ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Morbidity And Mortality ◽  
Aneurysm Surgery ◽  
Unruptured Intracranial Aneurysm ◽  
Perioperative Morbidity

Development of machine learning-based preoperative predictive analytics for unruptured intracranial aneurysm surgery: a pilot study

2020 ◽  
Vol 162 (11) ◽  
pp. 2759-2765
Author(s):  
Victor E. Staartjes ◽  
Martina Sebök ◽  
Patricia G. Blum ◽  
Carlo Serra ◽  
Menno R. Germans ◽  
...  
Keyword(s):  
Machine Learning ◽  
Pilot Study ◽  
Intracranial Aneurysm ◽  
Predictive Analytics ◽  
Aneurysm Surgery ◽  
Unruptured Intracranial Aneurysm

scholarly journals Recommencement of anticoagulation/antiplatelet therapy following non-operative management of a Chronic Subdural Hematoma – Is there an optimal time frame?

2021 ◽  
Vol 12 ◽  
pp. 456
Author(s):  
Savan Shah ◽  
K. Joshi George
Keyword(s):  
Conservative Management ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Operative Management ◽  
Time Frame ◽  
Primary Objective ◽  
Optimal Time ◽  
Male Predominance ◽  
Significant Difference ◽  
Non Operative Management

Background: There is no consensus among clinicians regarding recommencement of antithrombotic agents following conservative management of a Chronic Subdural Hematoma (cSDH). Thus, the primary objective of this study was to determine the most commonly recommended interval and whether the data reveal a general consensus that should be adopted. Methods: A retrospective analysis of Salford Royal Foundation Trust’s Neurosurgical referral database for patients referred with a cSDH between March 2017 and March 2020 was carried out. Patients were sorted by whether they were on blood-thinning medications. Results: Over the 3-year period, there were a total of 1220 referral and 1099 patients. 502 (41.14%) of these referrals and 479 (43.59%) patients were on one more blood thinning agent. Of these patients 221 (46.13%) conservative management, there was a clear male predominance (M: F ≈ 2.5:1) in this cohort. 2 weeks was the most commonly advised time-frame (n = 76, 36.36%) to withhold. Of the 234 referrals, there were 13 (5.88%) re-referrals in total. Crucially, there was no significant difference in reaccumulation rates between patients asked to withhold their blood thinners for 2 weeks versus those asked to stop for longer than 2 weeks (P = 0.57). Conclusion: For the majority of bleeds, there is no clear benefit from asking patients to withhold their anticoagulant/antiplatelet for longer than 2 weeks. In cases, where it is deemed appropriate to stop for longer than 2 weeks, clear instructions should be provided and documented along with reasons behind the decision.

scholarly journals Postoperative subdural hygroma and chronic subdural hematoma after unruptured aneurysm surgery: age, sex, and aneurysm location as independent risk factors

2016 ◽  
Vol 124 (2) ◽  
pp. 310-317 ◽  
Author(s):  
Jaechan Park ◽  
Jae-Hoon Cho ◽  
Duck-Ho Goh ◽  
Dong-Hun Kang ◽  
Im Hee Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Unruptured Aneurysm ◽  
Ct Scans ◽  
Aneurysm Surgery ◽  
Subdural Hygroma ◽  
Critical Age ◽  
Male Sex

OBJECT This study investigated the incidence and risk factors for the postoperative occurrence of subdural complications, such as a subdural hygroma and resultant chronic subdural hematoma (CSDH), following surgical clipping of an unruptured aneurysm. The critical age affecting such occurrences and follow-up results were also examined. METHODS The case series included 364 consecutive patients who underwent aneurysm clipping via a pterional or superciliary keyhole approach for an unruptured saccular aneurysm in the anterior cerebral circulation between 2007 and 2013. The subdural hygromas were identified based on CT scans 6–9 weeks after surgery, and the volumes were measured using volumetry studies. Until their complete resolution, all the subdural hygromas were followed using CT scans every 1–2 months. Meanwhile, the CSDHs were classified as nonoperative or operative lesions that were treated by bur-hole drainage. The age and sex of the patients, aneurysm location, history of a subarachnoid hemorrhage (SAH), and surgical approach (pterional vs superciliary) were all analyzed regarding the postoperative occurrence of a subdural hygroma or CSDH. The follow-up results of the subdural complications were also investigated. RESULTS Seventy patients (19.2%) developed a subdural hygroma or CSDH. The results of a multivariate analysis showed that advanced age (p = 0.003), male sex (p < 0.001), middle cerebral artery (MCA) aneurysm (p = 0.045), and multiple concomitant aneurysms at the MCA and anterior communicating artery (ACoA) (p < 0.001) were all significant risk factors of a subdural hygroma and CSDH. In addition, a receiver operating characteristic (ROC) curve analysis revealed a cut-off age of > 60 years, which achieved a 70% sensitivity and 69% specificity with regard to predicting such subdural complications. The female patients ≤ 60 years of age showed a negligible incidence of subdural complications for all aneurysm groups, whereas the male patients > 60 years of age showed the highest incidence of subdural complications at 50%–100%, according to the aneurysm location. The subdural hygromas detected 6–9 weeks postoperatively showed different follow-up results, according to the severity. The subdural hygromas that converted to a CSDH were larger in volume than the subdural hygromas that resolved spontaneously (28.4 ± 16.8 ml vs 59.6 ± 38.4 ml, p = 0.003). Conversion to a CSDH was observed in 31.3% (5 of 16), 64.3% (9 of 14), and 83.3% (5 of 6) of the patients with mild, moderate, and severe subdural hygromas, respectively. CONCLUSIONS Advanced age, male sex, and an aneurysm location requiring extensive arachnoid dissection (MCA aneurysms and multiple concomitant aneurysms at the MCA and ACoA) are all correlated with the occurrence of a subdural hygroma and CSDH after unruptured aneurysm surgery. The critical age affecting such an occurrence is 60 years.

Postoperative Delayed Paradoxical Depression After Uncomplicated Unruptured Intracranial Aneurysm Surgery

2017 ◽  
Vol 99 ◽  
pp. 63-69 ◽  
Author(s):  
Tomas Garzon-Muvdi ◽  
Wuyang Yang ◽  
Andrew S. Luksik ◽  
Alejandro Ruiz-Valls ◽  
Rafael John Tamargo ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Aneurysm Surgery ◽  
Unruptured Intracranial Aneurysm
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