Statistical Analysis of Chronic Subdural Hematoma in 309 Adult Cases

Abstract

Chronic subdural hematoma is a common disease. Occasionally, however, it is so puzzling to make a diagnosis clearly and immediately, that the delay of the manage ment may occur. So the purpose of this paper is to clarify the general picture of chronic subdural hematoma from a statistical analysis in 309 adult cases. Through this survey the role of trauma as the triggering factor is to be checked and the signs and symptoms will be summarized and divided into groups according to clinical features, which will make the diagnosis easy and useful to dissolve the pitfall. Pathophysiology and dy namics of the capsule of the hematoma are investigated in some cases, and the dys function of the liver is also inquired. Follow-up study was performed, which will con tribute to the selection of the operative method. Materials and Methods Statistical Analysis History of Trauma History of trauma preceeding the onset of the disease was noted in 276 cases (89%), in which were the traffic accidents 47%, ordinary life 35%, sport accidents 10 %, industry accidents 3 %, and so on (Table 1). In sport accidents 9 cases were

Risk Factors and Outcome of Seizures After Chronic Subdural Hematoma

“…Although the frequency of seizures after CSDH is variously estimated at 2.3-23.4% [2][3][4][5], all data have been based on retrospective studies with variable follow-up. In the current study, seizures occurred in 11 out of 100 who had CSDH (11%), including acute symptomatic seizures in 6.0% (6/100) and unprovoked seizures in 5.0% (5/100).…”

“…The overall incidence of post-CSDH seizures reportedly varies from 2.3 to 17% [2,3], with a reported incidence of post-operative seizures between 1.0 and 23.4% [4,5]. Although one study has verified a significant increase in morbidity and mortality associated with respiratory complications and status epilepticus in patients with newonset seizures after CSDH [6], the efficacy of prophylactic anti-convulsive medication has been debated and its use is not consensual [3,6,7].…”

Prophylactic antibiotics and anticonvulsants in neurosurgery

“…Other retrospective studies considered the incidence of seizures in patients with CSH but did not include any control group for anticonvulsant therapy [54,70,61,73]. Given the lack of high-quality controlled trials and the clinical heterogeneity of the data from the available studies, pointing to the possibility of bias, no meta-analysis was performed.…”

“…The frequency of pre-and post-operative seizures in these patients is not established. The overall incidence of seizures in patients with CSH has been reported to vary from 2.3 to 17% [70,83] with an incidence of post-operative seizures reported from 1.0 to 23.4% [48,54]. The wide variation in these numbers is probably related to the severity of the head injury and the type of surgical procedure performed in each study.…”

Seizures in Subdural Hematoma

“…The surgical techniques employed in the treatment of SDH might also be important in the pathogenesis of seizures. Although the SDH capsule is thought to be the source of epileptogenesis, the incidence of postoperative seizures in patients who underwent capsulotomy was higher than in those who underwent burr-hole drainage [13,17,20]. This suggests that cortical injury and gliosis due to either surgical intervention or the SDH itself can result in late seizures [17].…”