A Radiological Assessment of Chronic Subdural Hematomas

Kwon, Sae Min; Lee, Min Ho; Seo, Young‐Joon; Kim, Young Il; Oh, Hyung Geun; Kim, Kyung Hwan; Choi, Kyu-Sun; Chong, Kyuha

doi:10.13004/kjnt.2022.18.e24

Cited by 16 publications

(15 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Acute SDH presents as a hyperdense collection in the subdural space, and bony sutures do not limit its extent 5 . Depending on the internal architecture, the acute‐on‐chronic SDH can present as homogenous, laminar, separated, and trabecular type 6 . The separated type can be identified as a high‐density collection below the lower‐density one with a clear margin between them and the high‐density collection showing recent bleeding 6 .…”

Section: Discussionmentioning

confidence: 99%

Coexistence of ipsilateral acute‐on‐chronic subdural hematoma and acute extradural hematoma: A case report

Basit

Javed

Shahzad

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

Extradural hematomas (EDH) and subdural hematomas (SDH) are extra-axial hemorrhages. Acute EDH is often observed in young people after traumatic brain injury. 1 In contrast, chronic SDH is more commonly observed in elderly patients following minor or unperceived traumas. 1 Chronic SDH can be attributed to various factors, such as anticoagulants, antiplatelet drugs, chronic alcoholism, and intracranial hypotension. 2 Acute-on-chronic SDH may occur; however, the coexistence of ipsilateral EDH is rare. 3 Herein, we present the case of ipsilateral traumatic EDH and ipsilateral acute-on-chronic SDH in an elderly male. | CASE REPORTA 65-year-old male presented to the emergency with loss of consciousness following a road traffic accident. The patient was in the driving seat, not wearing a safety belt. The collision details and the exact timing of the injury could not be established. Personal history revealed arterial hypertension, for which the patient was taking amlodipine and valsartan, and ischemic heart disease, for which the patient was taking aspirin and clopidogrel. His personal history, family history, and psychosocial history were unremarkable.The Glasgow Coma Scale (GCS) score was 7 at the presentation, and a dilated left-sided pupil was observed. His vitals were a pulse rate of 58 per minute, blood pressure of 140/90 mm of Hg, and respiratory rate of 35 cycles per minute. A detailed neurological examination was not possible in the emergency setting.Immediate orotracheal intubation was done, two widebore intravenous lines were opened, and resuscitation was done with 0.9% normal saline. His blood investigations did not show any abnormalities. Coagulation profile tests were not done as the patient needed emergency surgery. Following this, we did an urgent computed tomography (CT) scan of the head, which revealed subdural hematoma,

show abstract

Section: Discussionmentioning

confidence: 99%

Coexistence of ipsilateral acute‐on‐chronic subdural hematoma and acute extradural hematoma: A case report

Basit

Javed

Shahzad

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

“…One of the clinical challenges for CSDH is to suspect diagnosis and order head imaging dependent on basis non‐specific symptoms alone [1]. Clinically, non‐contrast computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used for the diagnosis of CSDH in most cases [16]. These scans can be completely normal with no signs of hemorrhage, however, the patients can still develop a CSDH weeks to month later [17].…”

Section: Discussionmentioning

confidence: 99%

LC‐MS‐based urine metabolomics analysis of chronic subdural hematoma for biomarker discovery

Sun,

Ou,

Liu

et al. 2023

Proteomics Clinical Apps

View full text Add to dashboard Cite

BackgroundChronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases with atypical manifestations. The aim of this study was to utilize urine metabolomics to explore potential biomarkers for the diagnosis and prognosis of CSDH.MethodsSeventy‐seven healthy controls and ninety‐two patients with CSDH were enrolled in our study. In total, 261 urine samples divided into the discovery group and validation group were analyzed by LC‐MS. The statistical analysis and functional annotation were applied to discover potential biomarker panels and altered metabolic pathways.ResultsA total of 53 differential metabolites were identified in this study. And the urinary metabolic profiles showed apparent separation between patients and controls. Further functional annotation showed that the differential metabolites were associated with lipid metabolism, fatty acid metabolism, amino acid metabolism, biotin metabolism, steroid hormone biosynthesis, and pentose and glucuronate interconversions. Moreover, one panel of Capryloylglycine, cis‐5‐Octenoic acid, Ethisterone, and 5,6‐DiHETE showed good predictive performance in the diagnosis of CSDH, with an AUC of 0.89 in discovery group and an AUC of 0.822 in validation group. Another five metabolites (Trilobinol, 3′‐Hydroxyropivacaine, Ethisterone, Arginyl‐Proline, 5‐alpha‐Dihydrotestosterone glucuronide) showed the levels of them returned to a healthy state after surgery, showing good possibility to monitor the recovery of CSDH patients.Conclusion and Clinical RelevanceThe findings of the study revealed urine metabolomic differences between CSDH and controls. The potentially diagnostic and prognostic biomarker panels of urine metabolites were established, and functional analysis demonstrated deeper metabolic disorders of CSDH, which might conduce to improve early diagnose of CSDH clinically.

show abstract

“…The mixed type included multilayered, separated, and trabecular types (Fig. 2) [12]. In addition, patient status was examined and classified based on the modified Rankin scale (mRS).…”

Section: Burr Hole Drainagementioning

confidence: 99%

Outcomes of chronic subdural hematoma and their correlations with old age

Lee

Jung

Park

et al. 2022

J Korean Soc Geriatr Neurosurg

View full text Add to dashboard Cite

Objective: This study explored the prognostic factors of chronic subdural hematoma in patients who underwent burr hole drainage, both overall and in elderly patients.Methods: This study enrolled 120 patients with chronic subdural hematoma who underwent burr hole drainage at a single center between January 2016 and December 2020. Old age was defined as >65 years, and a good prognosis was defined as a decrease in the modified Rankin scale from admission to the last follow-up. Factors correlated with good prognosis in elderly patients compared with total patients were evaluated using the chi-square test and logistic regression analysis.Results: Among the 120 patients, 66 (55.0%) were ≥65 years old, and 76 (63.3%) had severe symptoms on admission. Old age (≥65) was the only factor significantly correlated with severe symptoms (P=0.021; odds ratio [OR], 2.618; 95% confidence interval [CI], 1.154–5.942). The following variables were significantly associated with the prognosis in both groups: diabetes (total: P=0.008; OR, 0.207; 95% CI, 0.064–0.664; old age: P=0.011; OR, 0.017; 95% CI, 0.044–0.672) and severe symptoms on admission (total: P<0.001; OR, 6.994; 95% CI, 2.771–17.399; old age: P=0.007; OR, 6.177; 95% CI, 1.656–23.046).Conclusion: No difference in prognostic factors was observed between the overall patients and elderly patients with chronic subdural hematoma who underwent burr hole drainage. In both groups, patients without diabetes or with severe symptoms during hospitalization showed better recovery after burr hole drainage.

show abstract

A Radiological Assessment of Chronic Subdural Hematomas

Cited by 16 publications

References 61 publications

Coexistence of ipsilateral acute‐on‐chronic subdural hematoma and acute extradural hematoma: A case report

Coexistence of ipsilateral acute‐on‐chronic subdural hematoma and acute extradural hematoma: A case report

LC‐MS‐based urine metabolomics analysis of chronic subdural hematoma for biomarker discovery

Outcomes of chronic subdural hematoma and their correlations with old age

Contact Info

Product

Resources

About