Chronic Subdural Hematoma

Yang, Wuyang; Huang, Judy

doi:10.1016/j.nec.2016.11.002

Cited by 235 publications

(77 citation statements)

References 53 publications

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“…Also, elderly people have a higher chance of falling. As a result, age is the leading risk factor for cSDH (2).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of cSDH is 13.5 per 100,000 per year, and it is five times more in people older than 65 years (1). There are several treatment strategies for cSDH, including minimally invasive surgery, such as twist drill craniostomy and burr-hole craniostomy, or relatively highly invasive surgery, craniotomy (2). However, a high recurrence rate is observed in patients undergoing twist drill and burr-hole craniostomy because of inadequate exposure of hematoma cavities during surgery.…”

Section: Introductionmentioning

confidence: 99%

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Endoscope-Assisted Surgery vs. Burr-Hole Craniostomy for the Treatment of Chronic Subdural Hematoma: A Systemic Review and Meta-Analysis

et al. 2020

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Objectives: This article aims to evaluate the safety and effectiveness of endoscope-assisted surgery for chronic subdural hematoma (cSDH) in comparison with the burr-hole craniostomy. Methods: An electronic literature research was performed in MEDLINE, the Cochrane library, and EMBASE from the inception to February 18, 2020. A systematic review with meta-analyses was conducted to compare the efficacy of endoscope-assisted surgery with Burr-hole Craniostomy (BHC) surgery. Results: This meta-analysis included four studies comprising 441 patients. Endoscope-assisted surgery significantly decreased the risk of recurrence in patients with cSDH [odds ratio, 0.368; 95% confidence interval (CI), 0.178-0.759; P = 0.007; I 2 = 0%]. The complication rate was also significantly lower in the endoscope-assisted group (OR, 0.249; 95% CI, 0.07-0.882; P = 0.031; I 2 = 71.87%). Conclusion: We conducted the first meta-analysis of endoscope-assisted surgery for cSDH. The meta-analysis of four studies comprising 441 patients with cSDH suggests a significantly decreased risk of recurrence and postoperative complications after endoscope-assisted surgery. Therefore, endoscope-assisted surgery is effective and safe in treating cSDH.

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“…Also, elderly people have a higher chance of falling. As a result, age is the leading risk factor for cSDH (2).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoscope-Assisted Surgery vs. Burr-Hole Craniostomy for the Treatment of Chronic Subdural Hematoma: A Systemic Review and Meta-Analysis

et al. 2020

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“…The study was retained as it involved all potential cases presenting to a generic children's hospital and as SDHs are deemed to be extremely rare in young children and an important indicator for CM. 117 We included one unpublished dissertation from 2019, 59 specifically assessing ICD codes for CM.…”

Section: Study Characteristicsmentioning

confidence: 99%

Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis

et al. 2020

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ObjectiveElectronic health records (EHRs) are routinely used to identify family violence, yet reliable evidence of their validity remains limited. We conducted a systematic review and meta-analysis to evaluate the positive predictive values (PPVs) of coded indicators in EHRs for identifying intimate partner violence (IPV) and child maltreatment (CM), including prenatal neglect.MethodsWe searched 18 electronic databases between January 1980 and May 2020 for studies comparing any coded indicator of IPV or CM including prenatal neglect defined as neonatal abstinence syndrome (NAS) or fetal alcohol syndrome (FAS), against an independent reference standard. We pooled PPVs for each indicator using random effects meta-analyses.ResultsWe included 88 studies (3 875 183 individuals) involving 15 indicators for identifying CM in the prenatal period and childhood (0–18 years) and five indicators for IPV among women of reproductive age (12–50 years). Based on the International Classification of Disease system, the pooled PPV was over 80% for NAS (16 studies) but lower for FAS (<40%; seven studies). For young children, primary diagnoses of CM, specific injury presentations (eg, rib fractures and retinal haemorrhages) and assaults showed a high PPV for CM (pooled PPVs: 55.9%–87.8%). Indicators of IPV in women had a high PPV, with primary diagnoses correctly identifying IPV in >85% of cases.ConclusionsCoded indicators in EHRs have a high likelihood of correctly classifying types of CM and IPV across the life course, providing a useful tool for assessment, support and monitoring of high-risk groups in health services and research.

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“…Chronic subdural hematoma (CSDH) has become an increasingly common neurological condition worldwide, with an estimated incidence of up to 20.6 per 100,000 persons per year ( 1 ) and 58 per 100,000 per year for those 70 years of age and older ( 2 , 3 ). While CSDH management varies based on a host of patient characteristics and radiological factors, the mainstay of treatment is neurosurgical evacuation, typically via burr hole drainage (most common), craniotomy, or craniectomy.…”

Section: Introductionmentioning

confidence: 99%

Predicting Chronic Subdural Hematoma Resolution and Time to Resolution Following Surgical Evacuation

et al. 2020

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Background: Growing evidence suggests that chronic subdural hematoma (CSDH) may have long-term adverse effects even after surgical evacuation. Hematoma recurrence is commonly reported as a short-term, postoperative outcome measure for CSDH, but other measures such as hematoma resolution may provide better insight regarding mechanisms behind longer-term sequelae. This study aims to characterize postoperative resolution times and identify predictors for this relatively unexplored metric. Methods: Consecutive cases ( N = 122) of burr hole evacuation for CSDH by a single neurosurgeon at Columbia University Irving Medical Center from 2000 to 2019 were retrospectively identified. Patient characteristics, presenting factors, and date of hematoma resolution were abstracted from the electronic health record. Outcome measures included CSDH resolution at 6 months, surgery-to-resolution time, and inpatient mortality. Univariate and multivariate analyses were performed to determine predictors of outcome measures. Results: Hematoma resolution at 6 months was observed in 58 patients (47.5%), and median surgery-to-resolution time was 161 days (IQR: 85–367). Heavy drinking was predictive of non-resolution at 6 months and longer surgery-to-resolution time, while increased age was predictive of non-resolution at 6 months. Antiplatelet agent resumption was associated with non-resolution at 6 months and longer surgery-to-resolution time on univariate analysis but was not significant on multivariate analysis. Conclusion: Postoperative resolution times for most CSDHs are on the order of several months to a year, and delayed resolution is linked to heavy drinking and advanced age. Subsequent prospective studies are needed to directly assess the utility of hematoma resolution as a potential metric for long-term functional and cognitive outcomes of CSDH.

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Chronic Subdural Hematoma

Cited by 235 publications

References 53 publications

Endoscope-Assisted Surgery vs. Burr-Hole Craniostomy for the Treatment of Chronic Subdural Hematoma: A Systemic Review and Meta-Analysis

Endoscope-Assisted Surgery vs. Burr-Hole Craniostomy for the Treatment of Chronic Subdural Hematoma: A Systemic Review and Meta-Analysis

Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis

Predicting Chronic Subdural Hematoma Resolution and Time to Resolution Following Surgical Evacuation

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