Perioperative Lumbar Injection of Ringer's Lactate Solution in Chronic Subdural Hematomas: A Series of 100 Cases

Grisoli, F; Graziani, N; Péragut, Jean-Claude; Vincentelli, F; Fabrizi, Adele; Caruso, Giuseppe; Bellard, S.

doi:10.1227/00006123-198811000-00012

Cited by 55 publications

(26 citation statements)

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“…Other surgeons propose additional peri-operative lumbar intrathecal injection of Ringer's lactate solution after CSDH evacuation [5] or replacement of haematoma with oxygen after subdural tapping [1,2]. Prospective clinical trials with continuous irrigation-drainage have also been performed [14].…”

Section: Introductionmentioning

confidence: 99%

Chronic subdural haematoma ? a comparison of two different treatment modalities

1997

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Burr-hole craniotomy (BHC) and closed-system drainage undoubtedly is currently the most accepted treatment offered in chronic subdural haematoma (CSDH). Although twist-drill trephination (TDT) techniques have been available for years, now a special subdural catheter kit has been launched for treatment of CSDH. In a prospective study, 33 patients with 36 CSDH were treated with a 5-mm TDT regimen and insertion of a CORDIS subdural catheter (CORDIS Corp., Miami, USA). The results are compared with a consecutive series of 33 patients treated previously with an 11-mm BHC and closed-system drainage for 40 CSDH: Recurrence and persistence rate of CSDH treated with TDT necessitating a second intervention was 18.1%, no further surgical intervention was necessary. In BHC treated patients, 33.3% of haematomas had to be reoperated on, another 6.0% had to be re-operated on a third time. Infection rate in BHC treated patients was 18.1% as compared with a 0% infection rate in patients treated with the TDT technique. Mortality rate for the BHC method was 9.0% as compared with 6.0% in the TDT treatment regimen. Significantly better clinical results are achieved using the TDT technique with insertion of a special subdural catheter, making this procedure superior to the BHC regimen.

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Section: Introductionmentioning

confidence: 99%

Chronic subdural haematoma ? a comparison of two different treatment modalities

1997

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“…Several methods have been reported for reducing the amount of air remaining in the hematoma cavity and thus avoiding rebleeding. These include lumbar intrathecal injection of physiological saline or Ringer's solution during surgery [12,[37][38][39], the replacement of the hematoma with carbon dioxide gas [40] or oxygen [41], craniotomy without closure of the dura or replacing the bone plate [20], an implantation of a subcutaneous reservoir with a catheter introduced into the subdural cavity [41], or an overhydratation in the Trendelenburg position [2]. In 1988 Probst [43] reported a series of patients with CSDH treated by placement of a subdural-peritoneal shunt.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative collapse of the brain and intracranial hypotension have often gone hand in hand, for in itself intracranial hypotension is associated with lowered states of consciousness, reversible when the pressure rises [12]. The incidence of postoperative intracranial hypotension was 3% but in no case was there need for intrathecal or intraventricular injection of fluid, which has been advocated as a good method for producing the reexpansion of the brain [38]. McKissock et al [32] reported decreased intracranial pressure in 3.3% of 212 patients with hematomas, but recently higher percentages (10%) have been reported.…”

Section: Discussionmentioning

confidence: 99%

Chronic Subdural Hematoma Treated by Burr Holes and Closed Drainage System: A Review of 630 Cases

2001

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Objectives: To study the clinical features and surgical results of patients with chronic subdural hematoma. Methods: A retrospective study of the records of 630 patients treated surgically for chronic subdural hematoma using a burr hole and closed drainage system was conducted. Results: Six hundred and thirty patients (438 males and 192 females) ranging from 12 to 100 years with a mean age of 66.7 years were identified. Upon admission, 242 (38%) patients were in satisfactory condition (grades 0–1), 262 (42%) patients were at grade 2 and 126 (20%) were at grades 3 or 4. In 5.3% of the patients, surgical intervention was required to remove a recurring hematoma. In 77% of the patients, the results achieved could be graded as good (grades 0–1), with mortality being 2.5%. The only factor affecting the outcome was the grade at admission (p < 0.05). Conclusion: A simple and routinely used burr hole procedure either under local or general anesthesia with a closed drainage system is a safe and effective procedure for the treatment of chronic subdural hematoma.

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“…Clinical and radiological risk factors for developing seizures associated with chronic SDH include brain atrophy, mixed-density SDH, prior stroke, and low Glasgow Coma Scale (GCS) at presentation [16][17][18]. In patients with chronic SDH who underwent surgical intervention, the incidence of seizures is between 5 and 22 % in the acute postoperative period [17][18][19][20][21]. Predictors of seizures in this group include low GCS on admission, low postoperative GCS, acute-on-chronic SDH, and open craniotomy [17,18].…”

Section: Epidemiology Of Seizures In Subdural Hematomamentioning

confidence: 99%