Results of Exploration in Patients With Clinical Diagnosis of Subdural Hematoma

Bergman, Philip S.; Nathanson, M; Friedman, E. D.

doi:10.1001/jama.1952.02930340013005

Cited by 5 publications

(11 citation statements)

References 3 publications

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“…Unfortunately, this resulted in_a_neg-ative exploration rate of 30% to 50%. 1 In current practice almost all cases of subdural hematoma are confirmed by cerebral angiography and, once dem¬ onstrated, trephination is the usual treatment often without regard to the size of the hematoma or the clini¬ cal state of the patient.…”

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confidence: 99%

Nonsurgical Treatment of Subdural Hematomas

Bender¹,

Christoff²

1974

Archives of Neurology

180

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Between 1958 and 1973, one hundred patients with subdural hematoma were successfully treated without surgery. This was achieved either with bed rest, corticosteroids, mannitol, or a combination.The initial diagnosis and subsequent improvement were confirmed by cerebral angiography, but clinical observations were more important in deciding the selection of therapy. Similar medical treatment was initiated in 22 others who later were operated on because of failure to respond. Medical treatment was not attempted in severely ill or comatose patients. Of 185 patients with subdural hematoma in the Mount Sinai Hospital series, 75 recovered without surgery. After the introduction of corticosteroid therapy in 1968, there was a higher incidence of successful treatment by medical means. Follow-up examinations revealed that recovery was excellent and has been maintained.

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confidence: 99%

Nonsurgical Treatment of Subdural Hematomas

Bender¹,

Christoff²

1974

Archives of Neurology

180

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“…In over 80 per cent of cases there will be xanthochromia, bloody fluid, increased pressure, and/or an elevated concentration of protein. On the other hand, subdural hematoma may be present with completely normal cerebrospinal fluid findings (9). These data, however, do not help in differentiating subdural hematoma from other intracranial lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Carotid angiography in cases of subdural hematoma has disclosed a characteristic pattern, viz. , in the antero‐posterior views of the arterial phase, there is a peripheral avascular space and a shift of the anterior cerebral artery to the opposite side (9, 10, 14, 15).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Subdural Hemorrhage in the Very Aged†

Moore

1955

J American Geriatrics Society

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“…Numerous studies (1–7) have shown the variability of the clinical manifestations of subdural hematoma, and the unreliability of particular physical signs as a basis for this diagnosis in persons of any age, yet the evidences are in some degree dependent upon the age of the victim. The particular characteristics of the disorder at the earliest extreme of life and in the young adult have received wide attention, but in the elderly they have been largely ignored.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Alcoholism was the reason for admission in a large percentage of the 100 patients whose course was analyzed by Bergman, Nathanson and Friedman (4). Only 16 per cent had been admitted for the treatment of injury to the head.…”

Section: Review Of the Literaturementioning

confidence: 99%

Chronic Subdural Hematoma in the Elderly: A Curable Lesion

Raskind

Metcalf

Weiss

et al. 1968

J American Geriatrics Society

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Thirty‐nine elderly patients were treated surgically for chronic subdural hematoma. Of the 34 who survived the postoperative period, 30 were restored to their pre‐illness states of activity and function; the remaining 4 had paraplegia or hemiparesis. Chronic subdural hematoma in patients past 60 years of age presents many difficulties in diagnosis. However, clues often may be elicited by careful inquiry into the history, thorough physical examination, echo‐encephalography, plain roentgenograms of the skull, and analysis of the cerebrospinal fluid. Subdural hematoma must be seriously considered in any person older than 60 with a history of recent personality changes, rapidly progressing senility, headaches, or neurological deficits, whether or not there has been any known trauma to the head. It is important to recognize that the lesion is often curable. The better results in our series were obtained in those cases in which diagnosis and surgical intervention were carried out early in the course of the illness.

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Results of Exploration in Patients With Clinical Diagnosis of Subdural Hematoma

Cited by 5 publications

References 3 publications

Nonsurgical Treatment of Subdural Hematomas

Nonsurgical Treatment of Subdural Hematomas

Diagnosis and Treatment of Subdural Hemorrhage in the Very Aged†

Chronic Subdural Hematoma in the Elderly: A Curable Lesion

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