Objective:-Chronic subdural hematoma (CSDH) is a common disease among the elderly and with increasing incidence in the younger population, we have chosen to focus on CSDH in the different age groups so we can differentiate between presentation and radiological finding and etiological factor in each groups. Methods :-We conducted a retrospective review of 196 patients undergoing surgery for CSDH over a period of five years (2011-2016). Risk factors such as age, head trauma, anticoagulant and/or antiplatelet agent therapy and co-morbidity were investigated along with gender, laterality, surgical method and recurrence. We divided our patient in four groups according to age. Results:-Seventy-two percent of the patients were male and the mean age was 70% years (range 2-92 years). Headache was the most common symptom of presentation (63%). Maximum numbers of patients were found in the age group 61-75 years 74(38%). Association of head trauma in each group is the main etiological factor. CSDH is associated with brain atrophy in elderly and older age group. Conclusion :-Recurrence and bilateral disease are more common in old age group .Trauma to head is most common etiological factor in each age group .brain atrophy is etiological factor associated with old age group. Antiplatelet or anticoagulant therapy is associated as risk factor for the CSDH in all age groups.The use of antiplatelet or anticoagulant should be restricted to truly indicated patients.
To Study the effect of Cranioplasty on cerebral blood flow with clinical outcome in a patient who underwent decompressive craniectomy Aims: This study was done to evaluate the effect of cranioplasty on CBF with computed tomography perfusion (CTP). It also aimed to determine the correlation between postcranioplasty CBF and clinical outcome. Settings and Design: Prospective observational study. Subjects and Methods: All patients had CTP done to determine precranioplasty CBF. CTP was repeated at 6 weeks postcranioplasty and clinical assessment at 6 and 24 weeks postcranioplasty. Results: The median value of ipsilateral CBF was 52. 9and 64.10 ml/min/100 g at precranioplasty and postcranioplasty.contralateral CBF also showed improvement from 67.4 to 74. 7 ml/min/100 g at precranioplasty and postcranioplasty.contralateral. Median value for mini mental state examination showed a significant difference with value of 22, 25, and 25.5 at precranioplasty, 6 and 24 weeks postcranioplasty (P = 0.001 and P < 0.001). Median value for frontal assessment battery was 12, 14.5, and 15 (P = 0.002 and P = 0.001). Conclusions: Cranioplasty can improve cortical perfusion for both ipsilateral and contralateral hemisphere. Cranioplasty was observed to have a therapeutic role in terms of clinical outcome improvement.ce
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