Chronic subdural haematoma in the elderly

Adhiyaman, Vedamurthy; Asghar, M.; Ganeshram, K N; Bhowmick, B K

doi:10.1136/pmj.78.916.71

Cited by 273 publications

(210 citation statements)

References 41 publications

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“…Estudos enfatizam também a atividade anticoagulante da trombomodulina expressa nos vasos sinusoidais quando estes são lesados, contribuindo para a perpetuação dos microssangramentos 11 . Os fatores associados incluem alcoolismo crônico, implante de shunts ventriculares, distúrbios de coagulação, epilepsia e trauma 1,3,[7][8][9][13][14][15][16][17] . A maioria dos pacientes se encontra a partir da terceira década 15 com maior incidência entre quinta e sexta décadas [13][14][15]18 , sendo que os homens são mais comumente afetados pela patologia que as mulheres 1,7,[14][15][16] .…”

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Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma

Yasuda

Morita

Nishimori

et al. 2003

Arq. Neuro-Psiquiatr.

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RESUMO -O objetivo deste estudo é analisar a evolução de pacientes com hematoma subdural crônico em relação aos achados do coagulograma. Foram analisados 161 pacientes operados no Hospital das Clínicas-UNICAMP entre abril de 1994 e 2000. Foi detectado um predomínio do sexo masculino (86,3%), da cor branca (85,1%) e da faixa etária na quinta década (mediana 57 anos). O estudo mostrou mortalidade maior no período pós-operatório entre os pacientes com valores de RNI (international normalized ratio) superiores a 1,25 e/ou trombocitopenia (p<0,001 e p=0,004, respectivamente) e mortalidade menor para os pacientes com antecedente de traumatismo cranioencefálico (76%) (p=0,044). Os resultados ressaltam a importância da avaliação pré-operatória com o coagulograma a fim de se corrigir possíveis alterações.PALAVRAS-CHAVE: hematoma subdural crônico, coagulação, mortalidade. Chronic subdural hematoma: study of 161 patients and the relationship with coagulation abnormalitiesABSTRACT-The chronic subdural hematoma represents one of the most frequent types of intracranial hemorrhage. One hundred sixty one patients operated in the Clinical Hospital of State University of Campinas -SP (UNICAMP) from April 1994 to May 2000, were analyzed retrospectively in order to characterize the population and to study the importance of the pre-operative coagulation analysis in the outcome. The majority of the population was male (86%), white (85.1%) and in the fifth decade (median age: 57 years). A high mortality index in the postoperative period was found in patients with INR (international normalized ratio) values greater than 1.25 and/or thrombocytopenia (p<0.001 and p=0.004 respectively). Patients with previous head injury history (76%) showed a lower mortality (p=0.044). The results stand out the importance of the pre-operative evaluation with coagulation studies in order to correct possible abnormalities.KEY WORDS: chronic subdural hematoma, coagulation, mortality. O hematoma subdural crônico (HSC) representa uma das formas mais frequentes de hemorragia intracraniana 1 e é considerado uma lesão benigna, ainda que cronicamente progressiva 1-3 . O maior acometimento de pacientes idosos leva a uma variedade de dificuldades diagnósticas e terapêuticas devido a inespecificidade dos sintomas bem como patologias associadas 1,4 . Na maioria dos casos a evolução sem a instituição do tratamento cirúrgico pode ser fatal tanto pela compressão cerebral exercida pelo hematoma quanto pelas doenças associadas 5 . Por outro lado o diagnóstico precoce e a drenagem cirúrgica permitem a recuperação completa na maioria dos casos 1 .O HSC é caracterizado por uma coleção encapsulada e bem delimitada entre a dura máter e a membrana aracnóide contendo uma mistura de sangue fluido e coagulado de vários estágios 5,6 . A fisiopatologia do hematoma subdural crônico tem sido alvo de estudos desde a publicação de Virchow em 1857, em que descrevia com detalhes a lesão como uma paquimeningite hemorrágica 2,7,8 . Apesar das diversas teorias desenvolvidas desde então, a su...

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Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma

Yasuda

Morita

Nishimori

et al. 2003

Arq. Neuro-Psiquiatr.

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“…It is often associated with structural brain damage, and presents within 72 h of the injury. 5 While those taking between 3 and 7 days to develop are classified as subacute subdural haematomas. CSDH is predominantly a disease of the elderly with a peak incidence in the sixth and seventh decade of life and is very rarely seen Fig.…”

Section: Discussionmentioning

confidence: 99%

Isolated unilateral IIIrd nerve palsy as the only sign of chronic subdural haematoma

Mishra

Shukla

Baranwal

et al. 2015

Medical Journal Armed Forces India

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“…Acute SDH more frequently occurs as a result of motor vehicle collisions in younger patients and falls in elderly patients, and acute SDH has worse outcomes (5). By contrast, chronic SDH often occurs in elderly individuals who sustain a minor injury or fall without a concomitant traumatic head injury (6).…”

Section: Introductionmentioning

confidence: 99%

“…In addition to head injury (direct trauma), studies have associated SDH risk with falls, advanced age, reduced cognitive function, use of anticoagulants or antiplatelet drugs, alcoholism, epilepsy, bleeding diathesis, and low intracranial pressure (6,7). Neurologic complications are important causes of morbidity and mortality in patients with ESRD (8).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD

Wang

Cheng

Lin

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives This study compared the risk of subdural hematoma (SDH) and subsequent mortality in hemodialysis (HD) and peritoneal dialysis (PD) patients with ESRD.Design, setting, participants, & measurements Claims data were obtained from the National Health Insurance Administration Research Database in Taiwan. This retrospective cohort study comprised 10,136 PD patients and 10,136 HD patients with newly diagnosed ESRD from 1998 to 2010. Patients were matched by propensity score and year of dialysis initiation. Incidence rates and hazard ratios of SDH as well as odds ratios of subsequent 30-day deaths from SDH were evaluated from the date of the first dialysis session to the date when SDH was diagnosed, or the date of renal transplantation, death, withdraw from insurance, or the end of the follow-up period (December 31, 2011).Results Median (25th percentile, 75th percentile) follow-up times for SDH events were 3.61 years (1.91, 6.33) and 3.33 years (1.83, 5.66) in the HD and PD cohorts, respectively. The overall SDH incidence rate (95% confidence interval [95% CI]) was 61.4% higher in the HD cohort than in the PD cohort (34. Conclusions HD patients have a higher risk of developing SDH than PD patients. Both patient groups have a high risk of mortality. Routine education on fall prevention is needed for dialysis patients.

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Chronic subdural haematoma in the elderly

Cited by 273 publications

References 41 publications

Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma

Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma

Isolated unilateral IIIrd nerve palsy as the only sign of chronic subdural haematoma

Comparison of Subdural Hematoma Risk between Hemodialysis and Peritoneal Dialysis Patients with ESRD

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