Surgical management of acute subdural hematoma: a comparison between decompressive craniectomy and craniotomy on patients treated from 2010 to the present in a single center

Ruggeri, Andrea; Cappelletti, Martina; Tempestilli, Martina; Fazzolari, Benedetta; Delfini, Roberto

doi:10.23736/s0390-5616.18.04502-2

Cited by 15 publications

(5 citation statements)

References 14 publications

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“…Consequently, they were assessed for eligibility and full-text screening, which led to the inclusion of 17 studies. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 The searching and screening process is shown in the flowchart ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Comparing surgical outcomes: Craniotomy versus decompressive craniectomy in acute subdural hematoma - A systematic review and meta-analysis

Nadeem,

Siddiqui,

Rais

et al. 2024

World Neurosurgery: X

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Section: Resultsmentioning

confidence: 99%

Comparing surgical outcomes: Craniotomy versus decompressive craniectomy in acute subdural hematoma - A systematic review and meta-analysis

Nadeem,

Siddiqui,

Rais

et al. 2024

World Neurosurgery: X

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“…This should also be done in accordance with Insitutional Protocols. In case of primary procedure, after the evacuation of a mass effect lesion (acute subdural hematoma) the decision whether to replace the bone flap or not is actually based on clinical and intraoperative parameters (18) and still subject to uncertainties that will be possibly clarified by the awaited results of the RESCUE-ASDH trial. The potential advantages of replacing the bone flap at the primary surgery avoids a future cranioplasty that have been reported to be associated with complications like infections, reoperations, extra-axial fluid collection, bone flap resorption and, scalp necrosis (19).…”

Section: Discussionmentioning

confidence: 99%

Basal Cisternostomy for Severe TBI: Surgical Technique and Cadaveric Dissection

et al. 2022

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IntroductionCisternostomy is emerging as a novel surgical technique in the setting of severe brain trauma. Different surgical techniques have been proposed with a variable degree of epidural bone work. We present here the surgical technique as it is currently performed in our Institution.MethodsAnatomical dissection of one adult cadaveric head, injected and non-formalin fixed was perfomed. A large right fronto-temporo-parietal craniotomy was accomplished. Extradural sphenoidal drilling till opening of the superior orbital fissure was performed. The microsurgical anatomy of basal cisternostomy was then explored.ResultsA step by step description of the surgical technique, enriched with cadaveric and intraoperative images, was made.ConclusionBasal cisternostomy is a promising surgical technique that does not necessarily include complex surgical maneuvers. Trained neurosurgeon can safely implement it in their clinical practice.

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“…The optimal surgical modality for evacuating an AcSDH remains a controversial and debated topic. 2,7,9,11,12,13 The clinical practice amongst neurosurgeons regarding the choice of surgical modality for treating an acute traumatic subdural hematoma varies widely around the globe. 2 The decision for carrying out a craniotomy or a decompressive craniectomy remains empirical and the treating neurosurgeon makes this decision based on his personal experience and the clinical status of the patient.…”

Section: Discussionmentioning

confidence: 99%

Surgical Modality as a Determinant of Survival and Neurological Outcome Following the Evacuation of Acute Subdural Hematomas

Altaf¹,

Sarwar²

2022

Pak J Neurol Surg

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Objective: We designed the present study to compare the clinical outcomes of the craniotomy and the decompressive craniectomy procedures that we had performed in our department for evacuating traumatic acute subdural hematomas. Material and Methods: We retrospectively analyzed the medical data of all the adult patients in whom a craniotomy or a decompressive craniectomy had been performed for evacuating acute traumatic subdural hematoma. The demographic data, the preoperative Glasgow Coma Scale (GCS), and the clinical outcome were studied. Results: A craniotomy had been carried out in five patients for traumatic AcSDH evacuation while in twelve patients a decompressive craniectomy had been performed. The mean preoperative GCS was 9 in the patients that underwent a craniotomy, whereas the mean preoperative GCS in the decompressive craniectomy group was 6.8. The overall mortality was 47%. In the craniotomy group, 4 (80%) patients survived and 1 (20%) patient expired. In the decompressive craniectomy group, 5 (41.7%) patients survived and 7 (58.3%) patients expired. The outcome in all the 9 surviving patients was favorable based on the Glasgow Outcome scale and all of them were independent of follow-up. Conclusion: Better clinical outcome was observed in patients who had undergone a craniotomy compared to those in whom a decompressive craniectomy had been performed. Patients that underwent a craniotomy were also in a better clinical status preoperatively compared to patients who underwent a decompressive craniectomy.

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Surgical management of acute subdural hematoma: a comparison between decompressive craniectomy and craniotomy on patients treated from 2010 to the present in a single center

Cited by 15 publications

References 14 publications

Comparing surgical outcomes: Craniotomy versus decompressive craniectomy in acute subdural hematoma - A systematic review and meta-analysis

Comparing surgical outcomes: Craniotomy versus decompressive craniectomy in acute subdural hematoma - A systematic review and meta-analysis

Basal Cisternostomy for Severe TBI: Surgical Technique and Cadaveric Dissection

Surgical Modality as a Determinant of Survival and Neurological Outcome Following the Evacuation of Acute Subdural Hematomas

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