Dare to date: age estimation of subdural hematomas, literature, and case analysis
Metrics details. A large craniotomy is usually the first choice for removal of traumatic acute subdural hematoma TASDH. To date, few studies have reported that TASDH could be successfully treated by twist drill craniostomy TDC alone or combined with instillation of urokinase. A total of 7 TASDH patients, who were presented and treated by TDC in this retrospective study between January and May , consisted of 5 men and 2 women, ranging in age from 65 to 89 average, The results showed that the mean time interval from injury to TDC was The mean distance of midline shift was The preoperative GCS in all patients ranged from 4 to 13 median, 9.
Acute Subdural Hematoma
Important User Information: Remote access to EBSCO’s databases is permitted to patrons of subscribing institutions accessing from remote locations for personal, non-commercial use. However, remote access to EBSCO’s databases from non-subscribing institutions is not allowed if the purpose of the use is for commercial gain through cost reduction or avoidance for a non-subscribing institution. Jul, Vol. Abstract: Introduction: Microscopic study of the organization of the Subdural Haemorrhage SDH verified against the time period can help us in the determination of its age which has serious medico-legal implications.
Chronic subdural hematoma CSDH is prevalent among elderly populations worldwide, and its mysterious pathogenesis has been discussed in the literature for decades. The issues remaining to be solved in regard to CSDH include the initiating events; the bleeding into the subdural space and the formation of the outer and inner membranes, its development; increase and liquefaction of hematoma, the optimal treatments, and the natural history.
The pathophysiology is becoming more clear due to recent findings from computed tomography studies and human models of CSDH. In this work, we review previous studies on CSDH and present a new integrated concept about the development of this common condition after head injuries. Already have an account? Login in here. Journal of Medical and Dental Sciences. Journal home Journal issue About the journal. Keywords: subdural fluid collection , chronic subdural hematoma , inflammation , neomembrane , head injury , craniotomy , unruptured cerebral aneurysms.
The conservative and pharmacological management of chronic subdural haematoma: a systematic review
The incidence of traumatic brain injuries is increasing globally, largely due to an increase in motor vehicle use in low-income and middle-income countries. Purpose The aim of study was to investigate the factors that modulate the prognosis of patients with traumatic acute subdural hematoma. All the data collected were statistically analyzed and the results were compared with the international results. Our recommendations were based on that comparison.
Results Mortality rate was The mean and SD of age in our study was
Skull fractures – dating, features that suggest abuse abuse. ○ Hyperacute subdural hematoma (SDH) – Retinal hemorrhages – features suggestive of NHT.
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Correspondence Address : Dr. Simple hematoma evacuation is often performed in cases of chronic subdural hematoma CSDH associated with arachnoid cysts ACs on the same side after head injury. Here, we present a case of a 3-year-old boy with right frontal—temporal subdural hematoma and an AC over the left frontal—temporal region. Treatment involved craniotomy with hematoma evacuation, but no drainage of contralateral AC was applied.
dated by history, when available. Hematomas were grouped as follows: acute, phase also suggests repeated hemorrhage. Acute. CSF subdural hygromas.
The increasing incidence of subdural hematoma may be linked to increasing use of antithrombotics, according to data published online Feb. A retrospective case-control study of 10, patients aged years with a first-time subdural hematoma, matched by age, sex, and year to , general controls, showed treatment with a vitamin K antagonist was associated with a 3. Over the course of the Danish population-based study, which covered , the prevalence of antithrombotic drug use more than doubled, from 31 individuals per 1, to At the same time, the incidence of subdural hematoma nearly doubled The increase in subdural hematoma was greatest among older patients, from While the risk of subdural hematoma was greatest for the shortest duration of treatment with low-dose aspirin, the risk remained steady across all durations of treatment with clopidogrel and did not vary significantly for direct oral anticoagulants or vitamin K antagonists.
Women were more likely to show an increased risk of subdural hematoma with low-dose aspirin or vitamin K antagonist than men. The analysis also showed that the association between low-dose aspirin and subdural hematoma was significantly higher for individuals aged years than for those aged years. Four authors declared funds from the pharmaceutical industry, including one advisory board position.
No other conflicts of interest were declared. Skip to main content. From the Journals.
Subdural Hemorrhage in Abusive Head Trauma: Imaging Challenges and Controversies
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Most commonly, subdural hemorrhages (SDH) result from injury to the bridging veins that lead to bleeding between the dura and arachnoid.
Surgery is the standard treatment for chronic subdural hematoma CSDH , one of the common problems in neurosurgical practice. Although medical treatment was used by some authors and found some positive results, it is not accepted by many authors. The aim of this review is to give overall view of the medical management of CSDH. Action of various drugs in the pathophysiological cascade of formation of CSDH was depicted.
The review of literature is done under three headings — the primary medical treatment of CSDH, adjuvant medical treatment with surgery, and the treatment of the recurrence. Various classifications of CSDH and the factors influencing the outcome of medical treatment are discussed. There is a role of medical treatment in a selected group of patients with CSDH. Well-designed, multicenter, randomized controlled trials are required to define the indications and standard protocols for the medical treatment of CSDH.
Rates of Repeated Operation for Isolated Subdural Hematoma Among Older Adults
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Abstract Acute subdural hematoma (aSDH) is among the most common There were no restrictions on date of publication or methodology.
A year-old female with no past medical history presented to the ED after multiple tonic-clonic seizures over the previous 12 hours, the longest lasting 20 seconds. She returned to baseline after each seizure, had no obvious signs of trauma, and did not exhibit any focal neurologic deficits. She denied illicit drugs or new medications. A family member noted that she had fallen from her bed approximately 3 feet high 2 days ago.
Non-contrast Computed Tomography CT of the Head showed a dense extra-axial collection along the left frontal and parietal regions, extending superior to the vertex with mild mass effect, but no midline shift. Intracranial hemorrhage ICH is a term to describe any abnormal bleeding within the bony confines of the skull. Most commonly, subdural hemorrhages SDH result from injury to the bridging veins that lead to bleeding between the dura and arachnoid maters.
Falls in the elderly are a common cause of SDH since diffuse cerebral atrophy leads to increased shear forces upon vasculature structures during the fall. The risk of SDH increases with the use of anti-thrombotic agents. Clinical presentation varies from asymptomatic to coma in 50 percent of acute SDH. Chronic SDH may present with headaches, light-headedness, cognitive impairment, and seizures.