Chronic Subdural Hematoma: A Historical and Clinical Perspective

Sahyouni, Ronald; Goshtasbi, Khodayar; Mahmoodi, Amin; Tran, Diem Kieu; Chen, Jefferson

doi:10.1016/j.wneu.2017.09.064

Cited by 86 publications

(70 citation statements)

References 51 publications

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“…Out of 36 patients who underwent 42 surgeries in the observed period, this study included a total of 31 patients, each with a single operation (31 in sum) for primary CSDH. Five patients were excluded due to the CSDH related to the previous surgery (4), and due to the significant acute clot formation (1). The remaining 6 surgeries were re-operations (two of these in a single patient), while one male left for re-operation in another institution after reoccurrence.…”

Section: Resultsmentioning

confidence: 99%

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Sitting position awake craniostomy with drainage for chronic subdural hematoma: A viable alternative?

et al. 2021

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Background / Aim. Chronic subdural hematoma (CSDH) is one of the most frequent neurosurgical conditions with an overall incidence ranging from 1.72 to 20.6 per 100,000persons per year. The surgical procedure for chronic subdural hematoma is relatively simple and usually performed in the supine position. Reported reoccurrence rates range from 11.7% to 28%. Postperative pneumocephalus was previously identified as a sole predictor of reoccurrence. This study evaluates the procedure in the sitting position and the possible impact on the reoccurrence rate. Methods. The study included 31 patients who underwent awake craniostomy with closed system drainage for chronic subdural hematoma (16 in supine and 15 in sitting position) in our department in the period from December 2016 to March 2018. Results. Twenty-two males and nine females were included in the study. The overall reoccurrence rate was 19% (22% and 18% in females and males respectively). The reoccurrence was noted in 5 patients who underwent surgery in the supine position, and in one case operated in sitting position. Our results revealed a lower reoccurrence rate in patients undergoing surgery in the sitting position, although not reaching statistical significance (OR: 0.18, CI: 0.01-1.42, p=0.172). Conclusion. Craniostomy in the sitting position under local anesthesia is a safe, simple, and reliable procedure for chronic subdural hematoma treatment. Apart from being very comfortable for the patient, according to our initial results, it might also lead to a lower reoccurrence rate, probably due to the better management of the air inflow, and consequential pneumocephalus. Apstrakt Uvod / Cilj. Hronični subduralni hematom je jedan od najčešćih neurohiruršklih entiteta sa ukupnom incidencom javljanja od 1,72 do 20,6 na 100 000 osoba godišnje. Hirurška procedura za lečenje CSDH je relativno jednostavna i obično se izvodi u ležećem položaju. Stopa recidiva iznosi od 11,7% do 28%. Postoperativni pneumocefalus se smatra 4 nezavisnim pojedinačnim prediktorom recidiva. Ova studija evaluira izvođenje procedure u sedećem položaju so eventualnim uticajem na stopu recidiva. Metode. Studija je obuhvatila 31 pacijenta kome je urađena kraniostomija sa zatvorenim sistemom za drenažu hroničnog subduralnog hematoma pod lokalnom anestezijom (16 u ležećem položaju na ledjima i 15 u sedećem), u periodu od decembra 2016., do maja 2018.godine. Rezultati. U studiju su bila uključena 22 muškarca i 9 žena. Ukupna stopa recidiva je iznosila 19% (22% kod žena i 18% kod muškaraca). Recidiv se javio kod 5 pacijenata operisanih u ležećem položaju i kod samo jedne pacijentkinje operisane u sedećem položaju. Naši rezultati su pokazali trend ređe pojave recidiva kod pacijenata operisanih u sedećem položaju, iako razlika u našoj grupi pacijenata nije statistički značajna (OR:0,18, CI:0,01-1,42, p=0,172). Zakljuĉak: Kraniostomija u sedećem položaju pod lokalnom anestezijom je sigurna, jednostavna i pouzdana procedura za lečenje hroničnog subduralnog hematoma. Pored toga što je veoma komforna za p...

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Section: Resultsmentioning

confidence: 99%

“…A subdural hematoma is a blood collection between the dura and arachnoid layers of meninges, which is considered chronic when developed in course of 21 days or more. [1] Chronic subdural hematoma (CSDH) is one of the most common neurosurgical occurrences, with the overall incidence reported to range from 1.72 to 20.6 per 100,000…”

Section: Introductionmentioning

confidence: 99%

Sitting position awake craniostomy with drainage for chronic subdural hematoma: A viable alternative?

et al. 2021

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“…[2] Furthermore, it has been suggested to consider CSDH as a form of reversible dementia, with a progressive decline in mental and physical performance, sometimes associated to clear focal neurological deficits, which can be reversed after treatment, at least to some degrees. [1] Based on these considerations, it is not surprising that this condition is central in the scientifical debate, as demonstrated by a large number of publications in the field. In 2017, 191 papers were reported in the medical literature on this topic, and in the first 9 months of 2018, of patients with CSDH is only partially dependent on the technical issue, it is, also, due to the patient's clinical condition, comorbidities, and medical therapies.…”

Section: Commentarymentioning

confidence: 99%

“…[6] Indeed, for some aspects, the final prognosis Although the incidence of chronic subdural hematoma (CSDH) is assessed about 1-5.3 case per 100,000 individuals yearly, this is a real emerging disease in consideration to the increasing average age of the general population. [1] For such reasons, this disease may have a deep effect on the socio-sanitary systems of many countries, leading to a progressive increase of healthcare costs and patient hospitalization. [1] Moreover, CSDH has a relevant impact, also, for patients: indeed, in fragile elderly ones, often with multiple comorbidities, the reduction of autonomous activities in daily life may lead to a relevant decrease of their quality of life, and according to some studies, also, to a reduction in the expected survival time.…”

Section: Commentarymentioning

confidence: 99%

“…[1] For such reasons, this disease may have a deep effect on the socio-sanitary systems of many countries, leading to a progressive increase of healthcare costs and patient hospitalization. [1] Moreover, CSDH has a relevant impact, also, for patients: indeed, in fragile elderly ones, often with multiple comorbidities, the reduction of autonomous activities in daily life may lead to a relevant decrease of their quality of life, and according to some studies, also, to a reduction in the expected survival time. [2] Furthermore, it has been suggested to consider CSDH as a form of reversible dementia, with a progressive decline in mental and physical performance, sometimes associated to clear focal neurological deficits, which can be reversed after treatment, at least to some degrees.…”

Section: Commentarymentioning

confidence: 99%

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Zoli

Serracchioli

Mazzatenta

2019

Journal of Neurosciences in Rural Practice

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LC‐MS‐based urine metabolomics analysis of chronic subdural hematoma for biomarker discovery

Sun,

Ou,

Liu

et al. 2023

Proteomics Clinical Apps

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BackgroundChronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases with atypical manifestations. The aim of this study was to utilize urine metabolomics to explore potential biomarkers for the diagnosis and prognosis of CSDH.MethodsSeventy‐seven healthy controls and ninety‐two patients with CSDH were enrolled in our study. In total, 261 urine samples divided into the discovery group and validation group were analyzed by LC‐MS. The statistical analysis and functional annotation were applied to discover potential biomarker panels and altered metabolic pathways.ResultsA total of 53 differential metabolites were identified in this study. And the urinary metabolic profiles showed apparent separation between patients and controls. Further functional annotation showed that the differential metabolites were associated with lipid metabolism, fatty acid metabolism, amino acid metabolism, biotin metabolism, steroid hormone biosynthesis, and pentose and glucuronate interconversions. Moreover, one panel of Capryloylglycine, cis‐5‐Octenoic acid, Ethisterone, and 5,6‐DiHETE showed good predictive performance in the diagnosis of CSDH, with an AUC of 0.89 in discovery group and an AUC of 0.822 in validation group. Another five metabolites (Trilobinol, 3′‐Hydroxyropivacaine, Ethisterone, Arginyl‐Proline, 5‐alpha‐Dihydrotestosterone glucuronide) showed the levels of them returned to a healthy state after surgery, showing good possibility to monitor the recovery of CSDH patients.Conclusion and Clinical RelevanceThe findings of the study revealed urine metabolomic differences between CSDH and controls. The potentially diagnostic and prognostic biomarker panels of urine metabolites were established, and functional analysis demonstrated deeper metabolic disorders of CSDH, which might conduce to improve early diagnose of CSDH clinically.

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Chronic Subdural Hematoma: A Historical and Clinical Perspective

Cited by 86 publications

References 51 publications

Sitting position awake craniostomy with drainage for chronic subdural hematoma: A viable alternative?

Sitting position awake craniostomy with drainage for chronic subdural hematoma: A viable alternative?

Commentary

LC‐MS‐based urine metabolomics analysis of chronic subdural hematoma for biomarker discovery

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