Microbleeds as a Prognostic Factor for Acute Subdural Hematoma

Abstract

This study investigated the frequency of poor outcome at discharge of acute subdural hematoma (SDH) patients with and without microbleeds. We retrospectively examined the records of 37 patients with acute SDH who were surgically treated with hematoma removal and received magnetic resonance (MR) imaging within 2 weeks of head injury onset. MR images were used to determine the presence or absence of microbleeds and contusional hemorrhage (CH). Patient outcome was categorized as good (moderate disability or good recovery) or poor (severely disability, vegetative state, or dead) according to the Glasgow Outcome Scale at discharge. Microbleeds were found in 23 patients (62%) and CH was found in 26 patients (70%). Fifteen patients (41%) had both microbleeds and CH. Poor outcome at discharge was more common in SDH patients with both microbleeds and CH than in SDH patients with neither microbleeds nor CH (14/15, 93% vs. 14/22, 64%; p ＝ 0.04). Poor outcome at discharge was more common in SDH patients under 60 years of age with microbleeds (6/8, 75%) than patients under 60 years of age without microbleeds (0/4, 0%; p ＝ 0.03). The location of the microbleed was not related to the outcome at discharge. These results suggest that the presence of microbleeds and CH on MR images may indicate poor prognosis in patients with acute SDH.

Prognostic Factors of Mortality and Functional Outcome for Acute Subdural Hematoma: A Review Article

“…1 ). 2 7 16 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 In the 42 articles within the quantitative analysis, 34 articles included patients operated on for ASDH, 2 16 24 25 26 27 30 31 33 34 35 37 38 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 …”

“…1). 2,7,16, In the 42 articles within the quantitative analysis, 34 articles included patients operated on for ASDH, 2,16,[24][25][26][27]30,31,[33][34][35]37,38,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][57][58][59][60][61] whereas seven articles included ASDH patients managed either medically or surgically. 7,28,29,32,36,39,56…”

“…Forty-three point nine percent (18/41) of the studies, accounting for 2,847 patients, reported clinical factors influencing the functional outcome of patients suffering from ASDH. 2,7,16,25,[28][29][30]32,[34][35][36]39,43,[49][50][51][52]57 Three factors were considered to be significantly associated with a poor functional…”

“…Thirty-six point six percent (15/41) of the studies, accounting for 2,608 patients, reported radiologic factors influencing the functional outcome of patients suffering from ASDH. 2,16,25,[28][29][30]32,[34][35][36]39,43,[49][50][51]…”

Traumatic brain injury-induced cerebral microbleeds in the elderly

“…They also promote psychiatric disorders such as major depressive episodes [3,4,9,16,22]. Presence of CMBs is linked to dysfunction in gait coordination and balance: shorter stride length and decreased general functionality [25][26][27][28].…”