Springer Nature. 2017 Aug 15;57(8):402-409. doi: 10.2176/nmc.ra.2016-0337. However, a high dose of atorvastatin can not only mobilize more EPC but also significantly increase the expression levels of vascular endothelial growth factor (VEGF), tissue growth factor- (TGF-), and matrix metalloproteinase-9 (MMP-9). Honda Y, Sorimachi T, Momose H, Takizawa K, Inokuchi S, Matsumae M. Neurol Res. Quan W, Zhang Z, Li P, Tian Q, Huang J, Qian Y, et al. Yip HK, Lee MS, Li YC, Shao PL, Chiang JY, Sung PH, Yang CH, Chen KH. By using this website, you agree to our 2021 Feb 1;57(2):125. doi: 10.3390/medicina57020125. Subdural Hematoma: Background, Pathophysiology, Etiology 16,3941) WebThe surgical draining will not get rid of 100 percent of the blood, but is designed to get rid of enough to: 1) relieve symptoms, and 2) promote the healing process, which is the body In the 1970s, the age of onset was most commonly 50 years old, 27) Kawamata T, Takeshita M, Kubo O, Izawa M, Kagawa M, Takakura K: Management of intracranial hemorrhage associated with anticoagulant therapy, Timing of the resumption of antithrombotic agents following surgical evacuation of chronic subdural hematomas: a retrospective cohort study, [Evaluation of surgical treatment for chronic subdural hematoma in extremely aged (over 80 years old) patients]. CAS Safety and efficacy of atorvastatin for chronic subdural hematoma in Chinese patients: a randomized clinical trial. CAS . . . Balser D, Farooq S, Mehmood T, Reyes M, Samadani U: Actual and projected incidence rates for chronic subdural hematomas in United States Veterans Administration and civilian populations, http://creativecommons.org/licenses/by-nc-nd/4.0/. Subdural hematoma: Definition, treatment, and outlook - Medical . Kudo H, Kuwamura K, Izawa I, Sawa H, Tamaki N: Chronic subdural hematoma in elderly people: present status on Awaji Island and epidemiological prospect. Front Neurol. In elderly CSDH patients, a history of trauma is less frequent than in younger CSDH patients. Case report. These symptoms were more often seen in patients over 80 years of age reported that there was no significant increase in the recurrence rate of CSDH after evacuation surgery between patients with early resumption of aspirin and those with late resumption Chronic; Health; Outcome; Subdural Haematoma. Liu X, Gao C, Yuan J, Xiang T, Gong Z, Luo H, et al. Stary JM, Hutchins L, Vega RA. CSDH is an important cause of morbidity and mortality, and it has been described as a sentinel health event indicating underlying systemic pathology Karibe H, Kameyama M, Kawase M, Hirano T, Kawaguchi T, Tominaga T: [Epidemiology of chronic subdural hematomas]. WebPMID: 31088769 DOI: 10.1016/j.jocn.2019.04.039 Aged Cognition Female Hematoma, Subdural, Chronic / epidemiology* Hematoma, Subdural, Chronic / surgery Humans Male 18,19,51,68) Sun TF, Boet R, Poon WS. cautioned that diagnosis of bilateral CSDH could be delayed by lack of brain shift symptoms. Chronic Subdural Haematoma in the Elderly: Is It Time for a New Paradigm in Management? and transmitted securely. https://doi.org/10.1007/s00701-016-2902-5. 59) 7) Bilateral chronic subdural hematoma: what is the clinical significance? The literature actually offers conflicting advice regarding CSDH treatment, and these lead to considerable variation in actual clinical prospect. The objective of this research was to assess long-term functional, cognitive, and mental health outcome after CSDH. Almenawer SA, Farrokhyar F, Hong C, et al. Google Scholar. Results were obtained in n = 51 patients. https://doi.org/10.1016/j.jns.2013.11.005. There are some differences in each country. 2015 Nov;37(11):985-92. doi: 10.1179/1743132815Y.0000000083. People who survive an acute subdural haematoma usually take a long time to recover from the effects of the haematoma. The recovery time will depend on the severity of the haematoma. There can also sometimes be permanent physical and mental disabilities. . Fujioka S, Matsukado Y, Kaku M, Sakurama N, Nonaka N, Miura G: [CT analysis of 100 cases with chronic subdural hematoma with respect to clinical manifestation and the enlarging process of the hematoma (authors transl)], Present epidemiology of chronic subdural hematoma in Japan: analysis of 63,358 cases recorded in a national administrative database. In recent reports from the US and Europe, discharge destination has been discussed. Careers, Unable to load your collection due to an error. . Olanzapine is recommended to treat patients with mental and emotional disorders (low-quality evidence, strong recommendation). . , thus, the MMA may be related to the bleeding mechanism. At the same time, the transfer to surgery rate decreased significantly in the atorvastatin treatment group. J Neurosurg. . https://doi.org/10.1016/j.clineuro.2004.09.015. Epub 2017 Mar 16. https://doi.org/10.1016/j.wneu.2016.03.062. Methods: reported that twist-drill craniotomy (TDC), BHS, and open craniotomy have approximately the same mortality rate (24%); open craniotomy has significantly higher morbidity, and TDC has a higher rate of recurrence, suggesting that BHS is the preferred technique Effects of atorvastatin on the inflammation regulation and elimination of subdural hematoma in rats. (Table 2). Symptomatic calcified chronic subdural hematoma in an elderly Resumption of antithrombotic drugs should be started as soon as possible if a patient has a high risk of thrombosis. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2017;14(1):167. https://doi.org/10.1186/s12974-017-0934-2. 30). . Honda Y, Sorimachi T, Momose H, Takizawa K, Inokuchi S, Matsumae M: Chronic subdural haematoma associated with disturbance of consciousness: significance of acute-on-chronic subdural haematoma. Accessibility Google Scholar. eCollection 2021. Miranda LB, Braxton E, Hobbs J, Quigley MR: Chronic subdural hematoma in the elderly: not a benign disease, A prospective study of chronic subdural haematomas in elderly patients. Gross survival increased from 59% in 1994 to 1998 to 73% in 2009 to 2013. Can J Neurol Sci. . . We modified the original figure from Weigel et al. . Resumption of antithrombotic drugs after evacuation surgery for CSDH is highly variable, and so far there have been no guidelines regarding the timing of resumption 2022 Mar 18;13:94. doi: 10.25259/SNI_911_2021. Federal government websites often end in .gov or .mil. Previous reports on the treatment of CSDH with high-dose dexamethasone showed that the dose of dexamethasone was generally 1216 mg/day, and the total dose of treatment course was more than 336 mg [38]. The antifibrinolytic therapy of CSDH has received increasing attention. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Subdural Hematoma (SDH) A guide for patients and Case 22-2019: a 65-year-old woman with weakness, dark urine, and dysphagia. 2016 Apr;88:569-575. doi: 10.1016/j.wneu.2015.10.045. Under multivariable analysis, variables independently associated with survival were year of Other studies have confirmed that immune regulation abnormity and decrease in vascular repair and maturation ability play important roles in the formation and development of CSDH [13,14,15]. Further observations on nonsurgical treatment. 2015;6(1):127. https://doi.org/10.4103/2152-7806.161788. Independent patients had a 1-year mortality of 42%, compared to 69% for dependent patients; 56% of patients taking antithrombotics and 30% of those without antithrombotics died within the first postoperative year. Chronic subdural hematoma: epidemiological and prognostic analysis of 176 cases. Ooba et al. The secretion of inflammatory cytokines and vascular endothelial growth factor (VEGF) leads to the proliferation of immature blood vessels on the hematoma wall, damage to vascular endothelial cells, opening of gap junctions, and increase of permeability. Cook et al. This consensus will also be updated with time, looking forward to a greater breakthrough in the research on CSDH. However, the effect of prophylactic use of antiepileptic drugs is uncertain. Weigel et al. Kutty RK, Peethambaran AK, Sunilkumar, Anilkumar M. Conservative treatment of chronic subdural hematoma in HIV-associated thrombocytopenia with tranexamic acid. Therefore, this consensus does not recommend these drugs. In 1970s, 1980s, and 1990s, most patients with CSDH were in their 50s (- - -), in their 60s (.), and in their 70s (- - -)) respectively. doi: 10.1371/journal.pone.0283958. Article Trials. 3) Miranda et al. 40) Li T, Wang D, Tian Y, Yu H, Wang Y, Quan W, et al. 2023 BioMed Central Ltd unless otherwise stated. : Usefulness of embolization of the middle meningeal artery for refractory chronic subdural hematomas, comparison of irrigation with artificial cerebrospinal fluid and normal saline in a cohort analysis. A retrospective study pointed out that high-dose dexamethasone (68 mg/day) could only save 17% of patients with CSDH from surgery, but significantly increased treatment complications [39]. Song Y, Wang Z, Liu L, Wang D, Zhang J. Corticosteroid treatment compared with surgery in chronic subdural hematoma: a systematic review and meta-analysis. It belies the notion that CSDH is a benign disease [22]. Drug treatment for CSDH combined with epilepsy: Epilepsy is one of the main complications before and after CSDH drilling and drainage. 2021 May 6;12:660885. doi: 10.3389/fneur.2021.660885. Effect of different factors on the short-term outcome of Chinese patients with primary chronic subdural hematoma at different age groups: a two-center retrospective study. https://doi.org/10.1007/s12028-015-0222-x. However, some studies believed that antifibrinolytic drugs could increase the incidence of thrombotic events in patients [54]. The treatment using osmotic dehydrating drugs such as mannitol, glycerin fructose, and diuretics can relieve the pain. What are the causative factors for a slow, progressive enlargement of a chronic subdural hematoma? It is suggested that surgical treatment should be used for patients whose clinical manifestations and neuroimages remain unimproved or deteriorate after a 2-week conservative treatment or more; the hematoma continues to increase, or such patients cannot tolerate drugs. Provided by the Springer Nature SharedIt content-sharing initiative. On the other hand, Kamenova et al. We reviewed all consecutive 75-year-old patients operated on for an ASDH between 2009 and 2012. The severity of the disease is often evaluated according to the size of hematoma and the degree of midline shift. 2021 Dec 3;11(12):e050786. Accessibility 8,28,29) Manivannan S, Spencer R, Marei O, Mayo I, Elalfy O, Martin J, Zaben M. BMJ Open. 8600 Rockville Pike Natural history of chronic subdural haematoma. Atorvastatin: an updated review of its pharmacological properties and use in dyslipidaemia. . Gelabert-Gonzalez M, Iglesias-Pais M, Garcia-Allut A, Martinez-Rumbo R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Lee GS, Park YS, Min KS, Lee MS. Spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. https://doi.org/10.1016/j.jns.2012.04.015. Patients treated with warfarin had 42.5-fold increase in incidence of CSDH Power A, Hamady M, Singh S, Ashby D, Taube D, Duncan N: High but stable incidence of subdural haematoma in haemodialysisa single-centre study, Subdural hematoma in regularly hemodialyzed patients, Subdural hematomas in chronic dialysis patients: significant and increasing. https://doi.org/10.6061/clinics/2013(08)04. 13) 2020:19. Brain Bleed, Hemorrhage (Intracranial Hemorrhage) - Cleveland Clinic Before and during the treatment of osmotic therapy, it is necessary to monitor the renal function and the change in electrolytes, so as to prevent the aggravation of renal insufficiency and the electrolyte disorder among elderly patients [56]. Please enable it to take advantage of the complete set of features! reported that resumption of antithrombotic drugs following surgical evacuation of CSDH should be at 3 days postoperatively because patients with a history of preoperative antithrombotic drugs experienced thromboembolic complications significantly earlier than those patients without antithrombotic drugs, which peaks at 3 days postoperatively, with no increased hemorrhage risk when antithrombotic drugs were restarted 12) 1974;40(5):63942. GRADE guidelines: 1. Acute subdural haematoma in the elderly: to operate or not to operate? 26) Epub 2015 Sep 7. Prognosis of patients with operated chronic subdural PMC https://doi.org/10.3171/2010.8.JNS10298. PubMed reported that age-specific frequencies of poor outcomes at discharge were 11.7%, 20.4%, 37.4%, and 56.8% for patients younger than 70 years old, or in their 70s, 80s, or 90s, respectively The cause of trauma was fallen in elderly patients and traffic accident was less than younger patients Phan K, Moore JM, Griessenauer C, Dmytriw AA, Scherman DB, Sheik-Ali S, Adeeb N, Ogilvy CS, Thomas A, Rosenfeld JV. Cookies policy. Xu X, Gao W, Cheng S, Yin D, Li F, Wu Y, et al. 2007;48(2):2107. However, most elderly patients can wait for surgery for approximately 12 hours after admission; then surgery can be performed after the half-life of the NOAC has passed. Kawamata et al. https://doi.org/10.3171/2014.5.JNS132715. . Tahsim-Oglou Y, Beseoglu K, Hnggi D, Stummer W, Steiger HJ: Factors predicting recurrence of chronic subdural haematoma: the influence of intraoperative irrigation and low-molecular-weight heparin thromboprophylaxis, A comparative study of treatments for chronic subdural hematoma: burr hole drainage versus burr hole drainage with irrigation, Surgical treatments for chronic subdural hematomas: a comprehensive systematic review, The role of postoperative patient posture in the recurrence of traumatic chronic subdural hematoma after burr-hole surgery, Complications of burr-hole craniostomy and closed-system drainage for chronic subdural hematomas: a retrospective analysis of 376 patients, Outcomes of chronic subdural hematoma with preexisting comorbidities causing disturbed consciousness, Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate, Long-term survival after chronic subdural haematoma. , and there are no reports about BHS with or without a drain in relationship to duration in elderly CSDH patients. For the specific treatment principles, please refer to the relevant consensus [44]. 25) As the world population becomes progressively older, the overall incidence is increasing. It can reduce the vascular leakage caused by the CSDH hematoma fluid, but its effect is weak. 15,20) https://doi.org/10.3171/jns.1981.55.3.0390. The clinical observations of patients with TBI confirm that the prognosis of patients with high EPC in the circulating blood is significantly better than that of patients with low EPC [25]. . Branco PM, Ratilal BO, Costa J, Sampaio C. Antiepileptic drugs for preventing seizures in patients with chronic subdural hematoma. See Table 2 for the GRADE classification method [62]. Chronic subdural hematoma: epidemiology and natural history.
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