Surgical Treatment Outcomes in Subdural Effusion: A Clinical Study

Abstract

Objective: In this study, patients who underwent surgery due to subdural effusion were retrospectively analyzed. The location, depth and etiology of the subdural effusion, the surgical approach that was used and the recurrence rates were studied in these patients. Method: A total of 32 patients who were followed up and treated for subdural effusion at the Neurosurgery Clinic of the Yüzüncü Yıl University School of Medicine were included in the study; 18 (56%) of the patients were male and 14 (44%) were female. The surgical techniques applied were surgical burr hole drainage, repeated subdural transaxial puncture and subduroperitoneal shunt approaches. The patients were evaluated by computerized tomography of the brain in week 1 and in the third month after surgery. Recurrences were evaluated based on radiological findings and the clinical condition of the patients. Result: The consciousness level of the patients was proportional to the mass effect of the subdural effusion. Lower recurrence rates were found in patients with a large midline shift resulting from the subdural effusion. In addition, recurrence rates were higher in patients with cerebral atrophy and lower protein content in the subdural effusion fluid. It was observed that these patients responded better to the subduroperitoneal shunt treatment.

Pediatric Traumatic Brain Injury: Characteristic Features, Diagnosis, and Management

“…Y-shunt technique often successfully reduces the amount of subdural fluid collection over a period of 2–3 months. 40) Good prognosis can be expected in such cases. However, in cases of AHT, delayed enlargement of subdural space is more likely to involve the bifrontal area, but may also reflect compensated subdural fluid collection alongside extensive bilateral atrophic change in the cerebral hemispheres, an injury condition referred to as enceplalomalacia.…”

Pleural effusion following ventriculo-pleural shunt: Case reports and review of the literature

“…Subdural effusion refers to an effusion in the subdural space, usually of CSF. [25] Normal intraventricular pressure ranges from 30 to 155 mm H2O in sitting posture. On insertion of VPS, this drops to an average of 25 mm H 2 O in adults.…”

Subdural effusion complicating neonatal meningitis: Successful treatment with acetazolamide

“…Treatment modalities include serial percutaneous needle drainage, burr hole drainage, external subdural drainage (ESD) and subdural to peritoneal shunt. [4][5][6][7][8][9][10][11][12] Sometimes the initial treatment may fail and another modality of treatment may be required.…”

“…[1][2][3] Various modalities of interventions are described in the literature. 4,5 Adequate treatment consists of prompt systemic administration of antibiotics combined with surgical drainage especially when there is a mass effect. 4,6 Treatment of subdural collections in infants with acetazolamide has been reported by few researchers.…”

“…4,5 Adequate treatment consists of prompt systemic administration of antibiotics combined with surgical drainage especially when there is a mass effect. 4,6 Treatment of subdural collections in infants with acetazolamide has been reported by few researchers. 7,8 We report treatment of SE complicating meningitis with acetazolamide in a neonate.…”