Bilateral chronic subdural hematoma: What is the clinical significance?

Huang, Yuhua; Yang, Ka-Yen; Lee, Tao-Chen; Liao, Chen-Chieh

doi:10.1016/j.ijsu.2013.05.007

Cited by 60 publications

(64 citation statements)

References 12 publications

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“…4,14 Bilateral cSDHs (bcSDHs) account for 17.4%-34.9% of cSDH cases. 7,17,19,21 Although there is no standardized treatment for cSDH and bcSDH, indication for surgery is generally accepted in symptomatic patients. Various surgical techniques have been used for years.…”

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confidence: 99%

“…1,2,[10][11][12]15 Moreover, in bcSDHs the retreatment rate reaches almost 30%. 7,13,19 Noted retreatment rates for bcSDHs in the literature depict both surgery for ipsilateral recurrence and surgery for contralateral progression after initial unilateral hematoma evacuation. Because of their different underlying pathomechanisms, ipsilateral recurrence and contralateral progression should be distinguished.…”

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confidence: 99%

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Contralateral progression after unilateral evacuation of bilateral chronic subdural hematomas: the volume relation ratio as prognostic factor?

Scheichel¹,

Popadic²,

Ungersboeck³

et al. 2019

Journal of Neurosurgery

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OBJECTIVEUnilateral evacuation of bilateral chronic subdural hematomas (bcSDHs) is associated with higher retreatment rates than an initial bilateral intervention. One reason for that is a possible progression in the size of the contralateral side after unilateral treatment. Thus, the authors focused their study on finding predictors of the need for contralateral retreatment.METHODSAll patients who had undergone unilateral or bilateral evacuation of bcSDHs in the Department of Neurosurgery at the University Hospital of St. Poelten during a 5-year period (7/2012 to 6/2017) were retrospectively identified. The preoperative hematoma volume was calculated using the XYZ/2 method.RESULTSOf a total of 103 patients with bcSDHs, 61 patients underwent bilateral evacuation and 42 patients underwent unilateral evacuation. The retreatment rate after bilateral evacuation was significantly lower than that after unilateral evacuation (14.8% vs 31%, respectively; p = 0.049). Contralateral retreatment after unilateral evacuation was necessary in 9 patients (21.4%). The preoperative contralateral hematoma volume was significantly higher in those patients who needed contralateral retreatment after initial unilateral evacuation (68.4 cm3 vs 27.4 cm3, respectively; p < 0.001). Furthermore, the so-called volume relation ratio created by dividing the smaller by the larger hematoma volume was significantly higher when contralateral retreatment became necessary (0.56 vs 0.21, respectively; p < 0.001).CONCLUSIONSPatients needing evacuation of bcSDHs should be considered for primary bilateral evacuation if the hematoma volume on the smaller side is greater than 40 cm3 and the subsequent volume relation ratio is greater than 0.4.

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confidence: 99%

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confidence: 99%

Contralateral progression after unilateral evacuation of bilateral chronic subdural hematomas: the volume relation ratio as prognostic factor?

Scheichel¹,

Popadic²,

Ungersboeck³

et al. 2019

Journal of Neurosurgery

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“…Finally good recovery was observed in 28 patients according to GLASGOW OUTCOME SCALE and they left for home with satisfactory condition. (Table-III 20 conducted study in Taiwan and found traumatic brain injury in 73 (74.49%) of 98 patients. Rovlias et al 21 in Brazil found TBI in 503 (51.01%) out of 986 patients.…”

Section: Resultsmentioning

confidence: 99%

Etiology and Surgical outcome of chronic Subdural hematoma at Tertiary Care Hospital.

Khan¹,

Rajar²,

Memon³

et al. 2019

TPMJ

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ABSTRACT… Objectives:To determine etiology and management outcome among patients presenting with chronic subdural hematoma at tertiary care Hospital. Study Design: Cross Sectional. Setting: Department of neurosurgery, Liaquat University Hospital, Hyderabad/ Jamshoro. Period: One year from 2015 to 2016. Material & Methods: All the patients with diagnosis of unilateral chronic subdural hematoma, and both male and female gender were included in this study. CT scan and other relevant laboratory investigations were done. All the patients underwent treatment of burr hole evacuation after taken informed consent. Antibiotics were given to all the patients pre-and post-operatively. All the subjects underwent CT scan for the evaluation of hematoma cavity. Patients were discharged generally following 1-week and were followed at outpatients department for 1-month, 3-months and 3-months, respectively. All the patients were assessed according to Glasgow Outcome Scale. Results: Over a period of one year; total thirty patients were selected, most of them were in the 6 th and 7 th decades of their lives and males were in majority 25(83%). Sixteen patients had a history of minor head injury, eleven patients had no obvious cause and one patient had chronic subdural hematoma secondary to over shunting. According to complications; intracerebral bleed was among 2(6%) cases and Pneumocephalus was in 2(6%) cases, followed by subdural empyema, acute subdural hematoma, extra dural hematoma, penetration into brain via drain catheter, C.S.F leakage and dysphasia were found in one patient, in each case, respectively. Almost every patient recovered and survival rate was 28(93%), while only two patients died. Conclusion: It was concluded that patients showed best outcome (93% survival rate) according to Glasgow Outcome Scale, after burr hole evacuation management. Head injury due to road traffic accident was the most common etiology and burr hole evacuation was the best treatment option for chronic subdural hematoma.

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“…In literature, the unilateral chronic subdural hematoma is more frequent than the bilateral one [1,2]. The incidence of a bilateral CSDH is about 16-20% in population [3]. However, why some patients have unilateral and other bilateral hematoma or what determines the site of CSDH is not still quite clear.…”

Section: Introductionmentioning

confidence: 99%

The question is whether hemiparesis is more common in unilateral than bilateral chronic subdural hematoma

2014

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The site and the form of intracranial lesion-chronic subdural hematoma could have a great influence on neurological and functional condition in a patient. Although the length of time required for making diagnosis as well as clinical symptoms greatly differ and the latter are not always so clear, physicians should maintain a high level of suspicion for this disease and thus contribute to prompt diagnosis and better clinical outcome of patients.

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Bilateral chronic subdural hematoma: What is the clinical significance?

Cited by 60 publications

References 12 publications

Contralateral progression after unilateral evacuation of bilateral chronic subdural hematomas: the volume relation ratio as prognostic factor?

Contralateral progression after unilateral evacuation of bilateral chronic subdural hematomas: the volume relation ratio as prognostic factor?

Etiology and Surgical outcome of chronic Subdural hematoma at Tertiary Care Hospital.

The question is whether hemiparesis is more common in unilateral than bilateral chronic subdural hematoma

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