The Role of Postoperative Patient Posture in the Recurrence of Traumatic Chronic Subdural Hematoma After Burr-Hole Surgery

Abouzari, Mehdi; Rashidi, Armin; Rezaii, Jalal; Esfandiari, Khalil; Asadollahi, Marjan; Aleali, Hamideh; Abdollahzadeh, Mehdi

doi:10.1227/01.neu.0000298908.94129.67

Cited by 163 publications

(114 citation statements)

References 20 publications

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…However, whether drainage alone or drainage with irrigation is better for patients with CSDH remains unclear [1,2,4,5,[10][11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Treatments for Chronic Subdural Hematoma: Burr Hole Drainage versus Burr Hole Drainage with Irrigation

2011

View full text Add to dashboard Cite

“…However, whether drainage alone or drainage with irrigation is better for patients with CSDH remains unclear [1,2,4,5,[10][11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Treatments for Chronic Subdural Hematoma: Burr Hole Drainage versus Burr Hole Drainage with Irrigation

2011

View full text Add to dashboard Cite

“…20 The study concluded that assuming an upright posture soon after burr-hole surgery is associated with an increased incidence of CSDH recurrence. Another study showed similar but statistically non-significant higher recurrence rate of CSDH with early sitting up posture in comparison to 3 days of bed rest.…”

Section: 13mentioning

confidence: 96%

“…Abouzari et al 20 conducted a study looking at the role of posture in post-operative patients in the recurrence of surgically managed traumatic CSDH. 20 The study concluded that assuming an upright posture soon after burr-hole surgery is associated with an increased incidence of CSDH recurrence.…”

Section: 13mentioning

confidence: 99%

“…34 The limitations of Abouzari et al 20 study was that they only studied patients with a history of head trauma and excluded those with shunts, seizures, alcohol abuse or use of anticoagulants. While up to 40% of patients with CSDH cannot recall a history of trauma, 35 this very homogenous study group in the Abouzari et al 20 trial brings the generalizability of the trial into question. In the same study recurrence was defined by radiological criteria, and despite the radiological recurrence rate was significantly higher in the patients who assumed a headelevated position immediately after surgery, these recurrences did not seem to affect the patients' clinical recovery and only one patient required surgery to drain the recurrent haematoma, 20 the study was inadequately powered and no details for statistical analysis was included, therefore scored 1 in the Harbour and Miller hierarchy of ranking.…”

Section: 13mentioning

confidence: 99%

“…While up to 40% of patients with CSDH cannot recall a history of trauma, 35 this very homogenous study group in the Abouzari et al 20 trial brings the generalizability of the trial into question. In the same study recurrence was defined by radiological criteria, and despite the radiological recurrence rate was significantly higher in the patients who assumed a headelevated position immediately after surgery, these recurrences did not seem to affect the patients' clinical recovery and only one patient required surgery to drain the recurrent haematoma, 20 the study was inadequately powered and no details for statistical analysis was included, therefore scored 1 in the Harbour and Miller hierarchy of ranking. 10 Another study looking at the "radiological factors" associated with risks of CSDH recurrence, showed increased risk of rebleed in patients with parietal or occipital drainage compared to those who had frontal burr hole drainage.…”

Section: 13mentioning

confidence: 99%

See 2 more Smart Citations

Chronic Subdural Haematoma: Systematic Review Highlighting Risk Factors for Recurrent Bleeds

Abdelsadg¹,

Kanodia²,

Abbas³

et al. 2017

Neuro – Open Journal

View full text Add to dashboard Cite

Citation Systematic ReviewPage 16 ABSTRACTIntroduction: Chronic subdural haematoma (CSDH) is one of the commonest forms of intracranial haemorrhage. Surgical drainage of CSDH is a routine operation in the modern neurosurgical practice which has shown to be the most effective way in treating this entity; however, the incidence of recurrence of the haematoma post operatively remains as high as 26.5%. The risk factors for CSDH recurrence remains an area of ongoing research. Objective: We have conducted a systematic review to evaluate the available literature addressing the risk factors for CSDH recurrence, aiming to minimise or at least identify patients at higher risk of recurrence in order to decrease associated morbidity. Methods: Ovid via Medline, PubMed, and Google scholar databases were searched for eligible studies, search results were then limited to studies in English language, Humans and studies published within the last 5 years. The included studies were critically appraised using the Critical Appraisal Skills Programme (CASP) tool, and each study has then been ranked using the Harbour and Miller hierarchy of ranking.Results: Based on available evidence, we classified the risk factors associated with recurrence to patients', radiological, and surgical factors. Patient factors include history of seizures, trauma, alcoholism, brain atrophy, and presence of CSF shunts, while the role of diabetes in relation to the recurrence is controversial. Radiologically the presence of air in the subdural space post-operatively, the width of the haematoma, and the presence of bilateral CSDHs are associated with increased risk of recurrence. While the predictive value of multiple membranes in the CSDH remains controversial. Surgically, the risk of recurrence was noted to be higher in patients with parietal or occipital compared to those who had frontal burr hole drainage, also placing a subdural drain decreases the chance of recurrence and some evidence showed better outcomes for frontally placed drains. The role of anti-inflammatory agents (including steroids) remains an area of ongoing debate. Conclusions: Risk factors for CSDH can be divided into patients', radiological, and surgical factors. We encourage health care providers to minimize if not prevent potentially avoidable factors. Patients with increased risks for recurrence should be identified early by the treating team and when possible should be informed about their higher than usual risk of recurrence. Moreover this review highlights the general lack of a sufficiently powered class I evidence addressing this topic and that further research is required in this topic.

show abstract

Postoperative Complications of Cranial Chronic Subdural Hematoma

Akhaddar

2021

Subdural Hematoma

View full text Add to dashboard Cite

The Role of Postoperative Patient Posture in the Recurrence of Traumatic Chronic Subdural Hematoma After Burr-Hole Surgery

Cited by 163 publications

References 20 publications

A Comparative Study of Treatments for Chronic Subdural Hematoma: Burr Hole Drainage versus Burr Hole Drainage with Irrigation

A Comparative Study of Treatments for Chronic Subdural Hematoma: Burr Hole Drainage versus Burr Hole Drainage with Irrigation

Chronic Subdural Haematoma: Systematic Review Highlighting Risk Factors for Recurrent Bleeds

Postoperative Complications of Cranial Chronic Subdural Hematoma

Contact Info

Product

Resources

About