Effects of Possible Osteoporotic Conditions on the Recurrence of Chronic Subdural Hematoma

Ha, Byeong Jin; Bae, In‐Suk; Kim, Jae Min; Cheong, Jin Hwan; Ryu, Je Il; Han, Myung‐Hoon

doi:10.3389/fneur.2020.538257

Cited by 4 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this study shows that antithrombotic use is not associated with CSDH recurrence. There are also some retrospective studies that have yielded similar results ( 10 , 36 , 45 , 46 ). Preoperative antithrombotic use does not seem to influence the rate of CSDH recurrence and early antithrombotic recommencement may reduce the risk of thromboembolic events ( 45 , 46 ).…”

Section: Discussionmentioning

confidence: 80%

“…Radiological variables including preoperative hematoma width, preoperative midline shift, preoperative hematoma volume, postoperative residual air accumulation, CT imaging of different types of CSDH, and the residual total hematoma cavity volume have already been considered as predictive factors for CSDH recurrence ( 27 , 36 , 37 ). In the present study, gradation and separated types, PostRCV ≥70 ml, PostRAV ≥28 ml, PostRHV ≥55 ml, residual hematoma width ≥1.4 cm, postoperative midline shift ≥5.6 mm, and postoperative brain re-expansion rate <41% are risk factors of recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Residual air accumulation in the subdural may also prevent good re-expansion of the compressed brain ( 40 ). Preoperative midline shift was considered a predictive factor for CSDH recurrence in many studies ( 11 , 36 ). This result may be attributed to the rapid expansion of the brain parenchyma after trephination, which exerts stress on the surrounding vessels and may contribute to acute rebleeding ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Peripheral blood eosinophil and classification of residual hematoma help predict the recurrence of chronic subdural hematoma after initial surgery

Chen

Shao

2022

Front. Surg.

View full text Add to dashboard Cite

Chronic subdural hematoma (CSDH) is a common type of intracranial hemorrhage in neurosurgical practice, whose incidence has increased markedly in recent years. However, CSDH still troubles clinicians with a high postoperative recurrence rate. The presence of eosinophils has been confirmed in some CSDH surgical specimens. Furthermore, postoperative residual hematoma has not been classified, and its association with the recurrence of CSDH remains unknown. The present study aimed to test the hypothesis that the peripheral blood eosinophils and the classification of postoperative residual hematoma are significant for the prediction of CSDH recurrence after burr-hole surgery. A retrospective review of 258 CSDH patients who received burr-hole surgery was performed. A complete blood picture with differential count was taken before surgery. Clinical, laboratory, and radiographic factors predicting CSDH recurrence were identified in univariable and multivariable analyses. Univariable analysis showed that the percentage of eosinophils, peripheral blood eosinophil count <0.15 × 109/L, gradation and separated types, postoperative volume of the residual cavity ≥70 ml, residual air volume ≥28 ml, residual hematoma volume ≥55 ml, residual hematoma width ≥1.4 cm, postoperative midline shift ≥5.6 mm, postoperative brain re-expansion rate <41%, postoperative low-density type, and postoperative high-density type correlated with the recurrence of CSDH. Multivariable analysis, however, showed that peripheral blood eosinophil count <0.15 × 109/L, gradation and separated types, preoperative midline shift ≥9.5 mm, postoperative brain re-expansion rate <41%, postoperative low-density type, and postoperative high-density type are independent predictors for the recurrence of CSDH. We expect that peripheral blood eosinophils and the classification of postoperative residual hematoma may facilitate our understanding of the recurrence of CSDH after initial surgery.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Peripheral blood eosinophil and classification of residual hematoma help predict the recurrence of chronic subdural hematoma after initial surgery

Chen

Shao

2022

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…A significant correlation between the Hounsfield unit (Hu) values of the skull and bone mineral density has been previously established (7). Furthermore, it was reported that patients exhibiting lower bone mineral density are at a heightened risk of experiencing recurrent CSDH (8). As a result, we have formulated the hypothesis that skull density is correlated with the progression of CSDH.…”

Section: Introductionmentioning

confidence: 83%

Predicting the progression of chronic subdural hematoma based on skull density

Yang,

Chen,

Yao

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveThe objective of this study was to investigate potential correlations between skull density and the progression of chronic subdural hematoma (CSDH).MethodsPatients with unilateral CSDH were retrospectively enrolled between January 2018 and December 2022. Demographic and clinical characteristics, as well as hematoma and skull density (Hounsfield unit, Hu), were collected and analyzed.ResultsThe study enrolled 830 patients with unilateral CSDH until the resolution of the CDSH or progressed with surgical treatment. Of the total, 488 patients (58.80%) necessitated surgical treatment. The study identified a significant correlation between the progression of CSDH and three variables: minimum skull density (MiSD), maximum skull density (MaSD), and skull density difference (SDD) (p < 0.001). Additionally, in the multivariable regression analysis, MiSD, MaSD, and SDD were independent predictors of CSDH progression. The MiSD + SDD model exhibited an accuracy of 0.88, as determined by the area under the receiver operating characteristic curve, with a sensitivity of 0.77 and specificity of 0.88. The model’s accuracy was validated through additional analysis.ConclusionThe findings suggest a significant correlation between skull density and the CSDH progression.

show abstract

“…Osteoporosis is a systemic disease that is strongly associated with genetic components of type 1 collagen [ 6 ]. Therefore, we previously hypothesized that low bone mineral density (BMD) would negatively influence the integrity of bridging veins, as veins are composed of smooth muscle cells [ 7 ]. Loss and degenerative changes in vascular smooth muscle cells negatively influence vascular strength, which can cause blood vessels to rupture easily [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Possible Osteoporosis on Parenchymal-Type Hemorrhagic Transformation in Patients with Cardioembolic Stroke

Won

Kim

Cheong

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

Background: hemorrhagic transformation (HT) is a frequent complication of ischemic stroke, and parenchymal hematoma (PH)-type HT has been shown to correlate with symptomatic deterioration. Because both bone and vascular smooth muscle cells are composed of type 1 collagen, we hypothesized that the integrity of blood vessels around the infarction area might be more damaged in osteoporotic conditions after a cardioembolic stroke. Methods: we measured frontal skull Hounsfield unit (HU) values on brain CT images from cardioembolic stroke patients. We conducted a receiver operating characteristic curve analysis in a large sample registry to identify the optimal HU threshold for predicting osteopenia and osteoporosis. Hazard ratios were estimated using a Cox regression analysis to identify whether osteoporotic conditions were an independent predictor of PH-type HT in patients with cardioembolic stroke. Results: altogether, 600 consecutive patients (>18 years old) with cardioembolic stroke were enrolled over a 12-year period at our hospital. The infarction volume and hypothetical osteoporosis were independent predictive factors for PH-type HT development in patients with cardioembolic stroke. In the male group, hypothetical osteoporosis was an independent predictor for PH-type HT development after cardioembolic stroke (hazard ratio, 4.12; 95% confidence interval, 1.40–12.10; p = 0.010). Conclusions: our study suggests an association between possible osteoporosis and the development of PH-type HT in patients with cardioembolic stroke. Our findings could help to predict PH-type HT by providing a convenient method for measuring the HU value using brain CT images.

show abstract

Effects of Possible Osteoporotic Conditions on the Recurrence of Chronic Subdural Hematoma

Cited by 4 publications

References 31 publications

Peripheral blood eosinophil and classification of residual hematoma help predict the recurrence of chronic subdural hematoma after initial surgery

Peripheral blood eosinophil and classification of residual hematoma help predict the recurrence of chronic subdural hematoma after initial surgery

Predicting the progression of chronic subdural hematoma based on skull density

Effect of Possible Osteoporosis on Parenchymal-Type Hemorrhagic Transformation in Patients with Cardioembolic Stroke

Contact Info

Product

Resources

About