Cargando…
Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage
OBJECTIVE: Rapid expansion of subacute subdural hematomas (saSDHs) is an uncommon complication in the course of acute subdural hematomas (SDHs). The current study evaluated relevant factors and treatment methods for saSDHs with neurologic deterioration and mass effect. METHODS: A saSDHs was chronolo...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Neurotraumatology Society
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218348/ https://www.ncbi.nlm.nih.gov/pubmed/30402422 http://dx.doi.org/10.13004/kjnt.2018.14.2.76 |
_version_ | 1783368430697578496 |
---|---|
author | Ha, Jong-Ho Park, Jong-Hyun Jeong, Je Hoon Im, Soo Bin Hwang, Sun-Chul |
author_facet | Ha, Jong-Ho Park, Jong-Hyun Jeong, Je Hoon Im, Soo Bin Hwang, Sun-Chul |
author_sort | Ha, Jong-Ho |
collection | PubMed |
description | OBJECTIVE: Rapid expansion of subacute subdural hematomas (saSDHs) is an uncommon complication in the course of acute subdural hematomas (SDHs). The current study evaluated relevant factors and treatment methods for saSDHs with neurologic deterioration and mass effect. METHODS: A saSDHs was chronologically defined as an SDH occurring 4 to 21 days after head trauma. All cases of surgically treated SDHs were retrieved from the head trauma bank at our institution. Twenty-three patients with expanding saSDHs who met the following criteria were enrolled in the study: defined age of the hematoma, clinical deterioration, and radiological expansion of the hematoma. Cases were analyzed according to demographic factors, trauma mechanism, medical co-morbidity, and surgical method. RESULTS: Expanding saSDHs occurred more often in older (≥60 years old) than in younger patients (69.6% vs. 30.4%, respectively); they also occurred more often in men than in women (64% vs. 36%, respectively). Antiplatelet or anticoagulant therapy was used in 52% of patients. The Glasgow Coma Scale score was 13 at the time of the trauma and deteriorated to 11 at the time of surgery. The mean time from the trauma to development of the expanding saSDH from an SDH was 13.3 days. Regarding surgical methods, closed-system drainage was performed in 22 patients, and only one patient underwent craniotomy with hematoma removal. All patients exhibited neurological improvements after surgery. CONCLUSION: An expanding saSDH usually occurs around 13 days after trauma in older adults. Minimal trephination with closed-system drainage can be used to manage an expanding saSDHs. |
format | Online Article Text |
id | pubmed-6218348 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Korean Neurotraumatology Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-62183482018-11-06 Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage Ha, Jong-Ho Park, Jong-Hyun Jeong, Je Hoon Im, Soo Bin Hwang, Sun-Chul Korean J Neurotrauma Clinical Article OBJECTIVE: Rapid expansion of subacute subdural hematomas (saSDHs) is an uncommon complication in the course of acute subdural hematomas (SDHs). The current study evaluated relevant factors and treatment methods for saSDHs with neurologic deterioration and mass effect. METHODS: A saSDHs was chronologically defined as an SDH occurring 4 to 21 days after head trauma. All cases of surgically treated SDHs were retrieved from the head trauma bank at our institution. Twenty-three patients with expanding saSDHs who met the following criteria were enrolled in the study: defined age of the hematoma, clinical deterioration, and radiological expansion of the hematoma. Cases were analyzed according to demographic factors, trauma mechanism, medical co-morbidity, and surgical method. RESULTS: Expanding saSDHs occurred more often in older (≥60 years old) than in younger patients (69.6% vs. 30.4%, respectively); they also occurred more often in men than in women (64% vs. 36%, respectively). Antiplatelet or anticoagulant therapy was used in 52% of patients. The Glasgow Coma Scale score was 13 at the time of the trauma and deteriorated to 11 at the time of surgery. The mean time from the trauma to development of the expanding saSDH from an SDH was 13.3 days. Regarding surgical methods, closed-system drainage was performed in 22 patients, and only one patient underwent craniotomy with hematoma removal. All patients exhibited neurological improvements after surgery. CONCLUSION: An expanding saSDH usually occurs around 13 days after trauma in older adults. Minimal trephination with closed-system drainage can be used to manage an expanding saSDHs. Korean Neurotraumatology Society 2018-10 2018-10-31 /pmc/articles/PMC6218348/ /pubmed/30402422 http://dx.doi.org/10.13004/kjnt.2018.14.2.76 Text en Copyright © 2018 Korean Neurotraumatology Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Article Ha, Jong-Ho Park, Jong-Hyun Jeong, Je Hoon Im, Soo Bin Hwang, Sun-Chul Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage |
title | Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage |
title_full | Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage |
title_fullStr | Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage |
title_full_unstemmed | Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage |
title_short | Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage |
title_sort | expanding subdural hematomas in the subacute stage and treatment via catheter drainage |
topic | Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218348/ https://www.ncbi.nlm.nih.gov/pubmed/30402422 http://dx.doi.org/10.13004/kjnt.2018.14.2.76 |
work_keys_str_mv | AT hajongho expandingsubduralhematomasinthesubacutestageandtreatmentviacatheterdrainage AT parkjonghyun expandingsubduralhematomasinthesubacutestageandtreatmentviacatheterdrainage AT jeongjehoon expandingsubduralhematomasinthesubacutestageandtreatmentviacatheterdrainage AT imsoobin expandingsubduralhematomasinthesubacutestageandtreatmentviacatheterdrainage AT hwangsunchul expandingsubduralhematomasinthesubacutestageandtreatmentviacatheterdrainage |