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[PMID]:28468224
[Au] Autor:Gan Q; Zhao H; Zhang H; You C
[Ad] Endereço:*Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu †Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, Kunming ‡Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
[Ti] Título:Rapid Spontaneously Resolving Acute Subdural Hematoma.
[So] Source:J Craniofac Surg;28(3):e287-e289, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: This study reports a rare patient of a rapid spontaneously resolving acute subdural hematoma. In addition, an analysis of potential clues for the phenomenon is presented with a review of the literature. PATIENT PRESENTATION: A 1-year-and-2-month-old boy fell from a height of approximately 2 m. The patient was in a superficial coma with a Glasgow Coma Scale of 8 when he was transferred to the authors' hospital. Computed tomography revealed the presence of an acute subdural hematoma with a midline shift beyond 1 cm. His guardians refused invasive interventions and chose conservative treatment. Repeat imaging after 15 hours showed the evident resolution of the hematoma and midline reversion. Progressive magnetic resonance imaging demonstrated the complete resolution of the hematoma, without redistribution to a remote site. CONCLUSIONS: Even though this phenomenon has a low incidence, the probability of a rapid spontaneously resolving acute subdural hematoma should be considered when patients present with the following characteristics: children or elderly individuals suffering from mild to moderate head trauma; stable or rapidly recovered consciousness; and simple acute subdural hematoma with a moderate thickness and a particularly low-density band in computed tomography scans.
[Mh] Termos MeSH primário: Traumatismos Craniocerebrais/complicações
Hematoma Subdural Agudo/diagnóstico
[Mh] Termos MeSH secundário: Hematoma Subdural Agudo/etiologia
Seres Humanos
Lactente
Imagem por Ressonância Magnética
Masculino
Remissão Espontânea
Fatores de Tempo
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003533


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[PMID]:29078871
[Au] Autor:Brooke M; Patel A; Castro-Moure F; Victorino GP
[Ad] Endereço:Department of Surgery, University of California San Francisco East Bay, Oakland, California. Electronic address: m.brooke.sanchez@gmail.com.
[Ti] Título:Shedding new light on rapidly resolving traumatic acute subdural hematomas.
[So] Source:J Surg Res;219:122-127, 2017 Nov.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rapidly resolving acute subdural hematomas (RRASDHs) have been described in case reports and case series but are still poorly understood. We hypothesized that a cohort analysis would confirm previously reported predictors of RRASDH including coagulopathy, additional intracranial hemorrhage, and low-density band on imaging. We also hypothesized that rapid resolution would be associated with improved trauma outcomes. METHODS: We reviewed all nonoperative acute subdural hematomas (ASDHs) treated at our center from 2011 to 2015. Inclusion criteria were ASDH on computed tomography (CT), admission Glasgow coma score >7, and repeat CT to evaluate ASDH change. RRASDH was defined as reduced hematoma thickness by 50% within 72 h. Clinical data, CT findings, and trauma end points were analyzed for the RRASDH and nonresolving groups. RESULTS: There were 154 ASDH patients included, with 29 cases of RRASDH. The RRASDH group had a lower rate of comorbidities than the nonresolving group (58.6% versus 78.4%, P = 0.03) and a lower rate of prehospital anticoagulation (7.7% versus 37.1%, P = 0.004). Previously reported predictors of RRASDH did not differ between the groups, nor did any clinical outcome measures. When compared with patients who experienced rapid growth (>50% increased width in 72 h), the RRASDH group had lower mortality (3.4% versus 23.5%, P = 0.04). CONCLUSIONS: To our knowledge, this is the largest review of RRASDHs. We identified two previously unrecognized factors that may predict resolution; however, previously reported predictors were not associated with resolution. We also found no relationship between RRASDHs and improved standard trauma outcomes, calling into question the clinical significance of RRASDH.
[Mh] Termos MeSH primário: Hematoma Subdural Agudo/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso de 80 Anos ou mais
Feminino
Escala de Coma de Glasgow
Hematoma Subdural Agudo/etiologia
Hematoma Subdural Agudo/mortalidade
Hematoma Subdural Agudo/terapia
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Remissão Espontânea
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171029
[St] Status:MEDLINE


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[PMID]:28991942
[Au] Autor:Koneri N; Muck A; Adams BD
[Ad] Endereço:Kendall Regional Medical Center, Miami, FL, USA.
[Ti] Título:Confusion recurs 2 weeks after fall.
[So] Source:J Fam Pract;66(10):635-637, 2017 Oct.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 77-year-old woman presented to the emergency department complaining of a headache following a syncopal episode (while standing) earlier that day. She said that she'd lost consciousness for several minutes, and then experienced several minutes of mild confusion that resolved spontaneously. On physical exam, she was oriented to person and place, but not time. She had a contusion in her left occipitoparietal region without extensive bruising or deformity. The patient had normal cardiopulmonary, abdominal, and neurologic exams. Her past medical history included hypertension and normal pressure hydrocephalus, and her vital signs were within normal limits. She was taking aspirin once daily. The patient's initial head and neck computerized tomography (CT) scans were normal, but she was hospitalized because of her confusion. During her hospitalization, the patient had mild episodic headaches that resolved with acetaminophen. The next day, her confusion resolved, and repeat CT scans were unchanged. She was discharged within 24 hours. Two weeks later, the patient returned to the hospital after her daughter found her on the toilet, unable to stand up from the sitting position. She was confused and experienced a worsening of headache during transport to the hospital. No recurrent falls or additional episodes of trauma were reported. A CT scan was performed. WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?
[Mh] Termos MeSH primário: Acidentes por Quedas
Confusão/etiologia
Hematoma Subdural Agudo/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Idoso
Feminino
Hematoma Subdural Agudo/etiologia
Hematoma Subdural Agudo/psicologia
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE


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[PMID]:28559067
[Au] Autor:Hotta K; Sorimachi T; Honda Y; Matsumae M
[Ad] Endereço:Department of Neurosurgery, Tokai University, Kanagawa, Japan.
[Ti] Título:Chronic Subdural Hematoma in Women.
[So] Source:World Neurosurg;105:47-52, 2017 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Sex differences in various diseases recently have been recognized as an important factor in the approach to more efficient preventive and therapeutic medicine. We clarified sex differences in the clinical characteristics of chronic subdural hematoma (CSDH) by comparing men and women with CSDH, as there is a well-known male predominance in the prevalence of CSDH. METHODS: Clinical factors and computed tomography findings were investigated retrospectively in 490 consecutive patients admitted to our hospital between 2006 and 2015 who were diagnosed with CSDH. RESULTS: On univariate analysis, women were significantly older than men (P < 0.05). In women, premorbid impaired activities of daily living, consciousness disturbance, acute-to-chronic subdural hematoma, and death as outcomes at discharge were significantly more frequent than in men (P < 0.05). In contrast, women had less frequent instances of good recovery and less alcohol intake (P < 0.05). Multivariate analysis demonstrated female sex as an independent predictor of consciousness disturbance at admission. Female sex also was identified as a predictor of death at discharge. CONCLUSIONS: We demonstrated sex differences in the clinical characteristics of CSDH. In the future, management of patients with CSDH with regard to sex differences in disease characteristics could be expected to improve the outcomes of women, which have been worse than in men.
[Mh] Termos MeSH primário: Hematoma Subdural Crônico/cirurgia
Procedimentos Neurocirúrgicos
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Hematoma Subdural Agudo/cirurgia
Seres Humanos
Masculino
Meia-Idade
Procedimentos Neurocirúrgicos/métodos
Estudos Retrospectivos
Fatores Sexuais
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE


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[PMID]:28415054
[Au] Autor:Oishi T; Takehara S; Yamamura Y; Tomida M; Ikegaya N; Seki G; Ohta N
[Ad] Endereço:Department of Neurosurgery, Yaizu Municipal Hospital.
[Ti] Título:[Hemodialysis Increases the Incidence of Post-Traumatic Seizure in Hemodialysis Patients with Traumatic Intracranial Hemorrhage].
[So] Source:No Shinkei Geka;45(4):303-309, 2017 Apr.
[Is] ISSN:0301-2603
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:BACKGROUND: In Japan, the number of hemodialysis patients increases every year, along with the average age of this patient population. Further, certain complications of hemodialysis make the care of traumatic head injury(THI)patients particularly difficult. OBJECTIVE: This study was aimed at investigating the occurrence of and risk factors for post-traumatic seizures in hemodialysis patients with a history of THI, and determining patient outcomes. METHODS: Subjects were selected from patients who were admitted to Yaizu Municipal Hospital in Shizuoka, Japan for traumatic intracranial hemorrhage(TICH). Retrospective medical histories of TICH patients who were and were not receiving hemodialysis were reviewed to investigate the risk factors for seizures and to determine patient outcomes. RESULTS: We identified 18 THI patients on hemodialysis and 86 THI patients not on hemodialysis treatment. We determined that predictive factors of post-traumatic seizure include:current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma. Moreover, 66.7% of seizures in our dialysis patients occurred during hemodialysis. Our data also suggest that Glasgow Coma Scale(GCS)scores on admission are a predictive factor for patient outcomes following discharge. CONCLUSION: Current hemodialysis treatment, enlargement of an existing hematoma, and an acute subdural hematoma are predictive factors of seizure occurrence in THI patients. As post-traumatic seizures triggered unfavorable outcomes in some dialysis patients, it is important to create appropriate plans for preventing dialysis disequilibrium syndrome that may lead to seizures in TICH/TIH patients on hemodialysis. We also determined that a low GCS score upon admission is a significant predictor of unfavorable outcomes.
[Mh] Termos MeSH primário: Hemorragia Intracraniana Traumática/epidemiologia
Diálise Renal/efeitos adversos
Convulsões/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Hematoma Subdural Agudo/complicações
Seres Humanos
Incidência
Hemorragia Intracraniana Traumática/etiologia
Hemorragia Intracraniana Traumática/terapia
Japão
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Convulsões/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE
[do] DOI:10.11477/mf.1436203500


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[PMID]:28325461
[Au] Autor:Al-Mufti F; Mayer SA
[Ad] Endereço:Endovascular Surgical Neuroradiology Program, Rutgers University-New Jersey Medical School, Newark, NJ, USA.
[Ti] Título:Neurocritical Care of Acute Subdural Hemorrhage.
[So] Source:Neurosurg Clin N Am;28(2):267-278, 2017 Apr.
[Is] ISSN:1558-1349
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence.
[Mh] Termos MeSH primário: Lesões Encefálicas/complicações
Cuidados Críticos
Hematoma Subdural Agudo/terapia
[Mh] Termos MeSH secundário: Pressão Sanguínea
Circulação Cerebrovascular
Hematoma Subdural Agudo/diagnóstico por imagem
Hematoma Subdural Agudo/etiologia
Seres Humanos
Pressão Intracraniana
Cuidados Pós-Operatórios
Ressuscitação
Convulsões/complicações
Convulsões/prevenção & controle
Úlcera Gástrica/complicações
Úlcera Gástrica/prevenção & controle
Tomografia Computadorizada por Raios X
Trombose Venosa/complicações
Trombose Venosa/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE


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[PMID]:28325459
[Au] Autor:Vega RA; Valadka AB
[Ad] Endereço:Department of Neurosurgery, Virginia Commonwealth University, 417 North 11th Street, 6th Floor, PO Box 980631, Richmond, VA 23298-0631, USA.
[Ti] Título:Natural History of Acute Subdural Hematoma.
[So] Source:Neurosurg Clin N Am;28(2):247-255, 2017 Apr.
[Is] ISSN:1558-1349
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Because published guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are based largely on case series and other weak evidence, management often must be individualized. Nonoperative management is a viable option in many cases. The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas. Close clinical and radiologic follow-up is needed, both acutely to detect rapid expansion of an ASDH, and subacutely to detect formation of a large subacute or chronic subdural hematoma.
[Mh] Termos MeSH primário: Hematoma Subdural Agudo/epidemiologia
Hematoma Subdural Agudo/terapia
[Mh] Termos MeSH secundário: Tomada de Decisão Clínica
Hematoma Subdural Agudo/diagnóstico por imagem
Hematoma Subdural Agudo/etiologia
Seres Humanos
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE


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[PMID]:28319470
[Au] Autor:Castellani RJ; Mojica-Sanchez G; Schwartzbauer G; Hersh DS
[Ad] Endereço:From the *Department of Pathology, University of Maryland School of Medicine, Baltimore, MD; †Center for Neuropathology, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI; and ‡Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD.
[Ti] Título:Symptomatic Acute-on-Chronic Subdural Hematoma: A Clinicopathological Study.
[So] Source:Am J Forensic Med Pathol;38(2):126-130, 2017 Jun.
[Is] ISSN:1533-404X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion. Given the prevalence of traumatic subdural processes in the forensic setting and the importance of proper assessment of timing, etiology, risk factors, and clinicopathological correlation, we studied 47 patients presenting to the University of Maryland Shock Trauma Center, all of whom underwent craniotomy with resection of the outer membrane due to symptomatic ACSDH. The surgically resected tissue was examined for histopathologic features in all cases. Our findings highlight that ACSDH is a condition precipitated by trauma that affects middle-aged and older adults, is relatively indolent, is unilateral or asymmetric, and has a low in-hospital mortality rate. Pathological analysis demonstrates a substantial outer membrane in all cases with varying degrees of inflammation and organization that cannot be precisely dated as a function of clinical presentation. The extrapolation of adult ACSDH to mixed acute and chronic subdural hemorrhage in the pediatric setting is problematic due to substantial differences in clinical presentation, severity of underlying brain injury, gross and microscopic findings, and outcome.
[Mh] Termos MeSH primário: Hematoma Subdural Agudo/patologia
Hematoma Subdural Crônico/patologia
[Mh] Termos MeSH secundário: Acidentes por Quedas/estatística & dados numéricos
Adulto
Idoso
Idoso de 80 Anos ou mais
Anticoagulantes/uso terapêutico
Craniotomia
Eosinófilos/patologia
Feminino
Escala de Coma de Glasgow
Hematoma Subdural Agudo/cirurgia
Hematoma Subdural Crônico/cirurgia
Seres Humanos
Masculino
Meia-Idade
Inibidores da Agregação de Plaquetas/uso terapêutico
Estudos Retrospectivos
Ferimentos e Lesões/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Platelet Aggregation Inhibitors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE
[do] DOI:10.1097/PAF.0000000000000300


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[PMID]:28315797
[Au] Autor:Phan K; Moore JM; Griessenauer C; Dmytriw AA; Scherman DB; Sheik-Ali S; Adeeb N; Ogilvy CS; Thomas A; Rosenfeld JV
[Ad] Endereço:NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia. Electronic address: kphan.vc@gmail.com.
[Ti] Título:Craniotomy Versus Decompressive Craniectomy for Acute Subdural Hematoma: Systematic Review and Meta-Analysis.
[So] Source:World Neurosurg;101:677-685.e2, 2017 May.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acute subdural hematoma (SDH) is a major cause of morbidity after severe traumatic brain injury. Surgical evacuation of the hematoma, either via craniotomy or craniectomy, is the mainstay of treatment in patients with progressive neurologic deficits or significant mass effect. However, the decision to perform either procedure remains controversial. METHODS: A literature search using major online databases and a manual search of references on the topic of craniotomy and craniectomy for evacuation of subdural hematoma until September 2016 was performed. The outcome variables were analyzed which included residual SDH, revision rate, and clinical outcome. RESULTS: Six comparison studies, with a total number of 2006 craniotomy and 451 craniectomy patients, fulfilled the inclusion criteria. Patients who underwent craniectomy scored significantly lower on the Glasgow Coma Scale at the time of initial presentation. Postoperatively, the rate of residual SDH was significantly lower in the craniectomy group than the craniotomy group (P = 0.004), with no difference in the revision rate. The odds of a poor outcome at follow-up was found to be lower in the craniotomy group (50.1% vs. 60.1%, respectively; P = 0.004). Similarly, mortality rates was lower in the craniotomy group than the craniectomy group (P = 0.004). CONCLUSIONS: The safety and efficacy of craniotomy versus decompressive craniectomy in treatment of acute SDH remain controversial. In this study, craniectomy was associated with worse clinical presentation and postoperative outcome compared with craniotomy. However, craniectomy was associated with lower rate of residual SDH after treatment.
[Mh] Termos MeSH primário: Craniectomia Descompressiva/métodos
Craniectomia Descompressiva/normas
Hematoma Subdural Agudo/mortalidade
Hematoma Subdural Agudo/cirurgia
[Mh] Termos MeSH secundário: Craniotomia/métodos
Craniotomia/normas
Hematoma Subdural Agudo/diagnóstico
Mortalidade Hospitalar/tendências
Seres Humanos
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/mortalidade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170320
[St] Status:MEDLINE


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[PMID]:28216211
[Au] Autor:Vilcinis R; Bunevicius A; Tamasauskas A
[Ad] Endereço:Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania.
[Ti] Título:The Association of Surgical Method with Outcomes of Acute Subdural Hematoma Patients: Experience with 643 Consecutive Patients.
[So] Source:World Neurosurg;101:335-342, 2017 May.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We investigated the association of decompressive craniectomy (DC) and osteoplastic craniotomy (OC) with outcomes in consecutive patients undergoing surgical evacuation of acute subdural hematoma (ASDH) and analyzed prognostic indicators to determine optimal surgical management strategy for patients with ASDH. METHODS: We performed a prospective review of all adult patients with ASDH operated on by craniotomy from January 2009 to January 2016. Mortality and discharge outcomes (Glasgow Outcome Scale) were analyzed as a function of surgical method adjusting for age, admission Glasgow Coma Scale score, ASDH thickness and midline shift. RESULTS: OC was performed in 394 (61%) patients, and DC was performed in 249 (39%) patients. Patients undergoing DC were younger, with lower Glasgow Coma Scale score, greater ASDH thickness, and greater midline shift (P < 0.001). Mortality rate (54% vs. 20%; P < 0.001) and proportion of patients with poor discharge outcomes (85% and 45%; P < 0.001) were greater in DC patients versus OC patients. Glasgow Outcome Scale score was lower and mortality rate was greater (P ≤ 0.048) in DC patients versus OC patients across all patient subgroups. Outcomes were similar between the 2 groups in patients with Glasgow Coma Scale score of 3 and midline shift of ≥2 cm. Adjusting for disease severity, DC remained associated with greater risk for in-hospital mortality (odds ratio = 3.442 [95% confidence interval 2.196-5.396], P < 0.001) and unfavorable discharge outcome (odds ratio = 5.277 [95% confidence interval 3.030-9.191], P < 0.001). CONCLUSIONS: DC was performed more often in younger and more severely injured patients. DC is associated with greater mortality and handicap rates independent of disease severity. Clinical trials investigating optimal surgical management strategy of patients with ASDH are needed.
[Mh] Termos MeSH primário: Craniectomia Descompressiva/mortalidade
Craniectomia Descompressiva/tendências
Hematoma Subdural Agudo/mortalidade
Hematoma Subdural Agudo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Hematoma Subdural Agudo/diagnóstico
Seres Humanos
Lituânia/epidemiologia
Masculino
Meia-Idade
Mortalidade/tendências
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170221
[St] Status:MEDLINE



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