Efficacy of Reinforced Restriction of Physical Activity on Chronic Subdural Hematoma: Prospective Pilot Study

Hou, Kun; Zhu, Xiaodong; Zhao, Jinchuan; Zhang, Yang; Gao, Xianfeng; Jiang, Kai; Li, Guichen

doi:10.1016/j.wneu.2017.11.155

Cited by 8 publications

(11 citation statements)

References 16 publications

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“…With reinforced restriction of physical activity, some stable patients could experience spontaneous resolution of the CSDH. According to our previous encouraging result, 7 we speculate that physical activity might play an important role in formation and progression of CSDH. We believe that this possibility is applicable to patients with SCFH.…”

Section: Discussionsupporting

confidence: 51%

“…3,4,11 In our previous study, we showed the efficacy of reinforced restriction of physical activity on CSDH in the general population. 7 Generally, the criteria of reinforced restriction of physical activity include the following: a) avoiding any type of work that is routinely performed when they are diagnosed with CSDH; b) avoiding any type of physical exercise; c) walking no more than 1 km per 24 hours; and d) bed rest for no less than 10 hours per 24 hours. However, we believe that reinforced restriction of physical activity is restriction of physical activity in a specific time interval rather than a concrete rule.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 In our recent prospective study, we showed that after reinforced restriction of physical activity all of the patients with CSDH experienced spontaneous resolution. 7 Therefore, we hypothesized that physical activity plays an important role in formation and progression of CSDH. Additionally, reinforced restriction of physical activity could also be used in patients with CSDH secondary to SCFH.…”

Section: Introductionmentioning

confidence: 99%

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Management of spontaneous cerebrospinal fluid hypovolemia-associated massive chronic subdural hematoma with reinforced restriction of physical activity: report of three cases

Lan-hua

Zhao

et al. 2020

J Int Med Res

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Spontaneous cerebrospinal fluid hypovolemia (SCFH) is an uncommon entity in neurosurgical practice. Without early recognition and management, some patients with SCFH can develop chronic subdural hematoma (CSDH). Generally, management of patients with SCFH without CSDH is relatively straightforward. However, this circumstance becomes more complicated in patients with concurrent CSDH. Treatment measures simply based on the respective management principles of SCFH and CSDH are insufficient or even disastrous. Our previous study showed that reinforced restriction of physical activity was a promising strategy in managing CSDH in the general population. We applied this strategy in three consecutive patients with SCFH and massive CSDH. All of the patients experienced complete resolution of CSDH. This study not only enriches the basic theory of formation and progression of CSDH, but also demonstrates that reinforced restriction of physical activity could be treated as an alternative or adjuvant management of CSDH secondary to SCFH.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of spontaneous cerebrospinal fluid hypovolemia-associated massive chronic subdural hematoma with reinforced restriction of physical activity: report of three cases

Lan-hua

Zhao

et al. 2020

J Int Med Res

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“…The AUC was under .90, which suggests that the relationship between the predicting factors and treatment outcome is more of an association than a causal relationship. There may be more complex interacting factors that were not included in our analysis, such as physical activity and alcohol use 41 . The mean hematoma volume of the case group in our study was 70.0 ml, which implies not only size but also manifestations of patient-speci c factors.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Wait and Watch Management for Primary Chronic Subdural Hematoma: A Retrospective Case–control Study

Zhang

Sha

Gao

et al. 2022

Preprint

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Prognostic factors in patients with primary chronic subdural hematoma (CSDH) taking the natural course are unclear. To identify independent influencing factors of wait-and-watch management, a case–control study of moderate CSDH patients using wait-and-watch as monotherapy in a single center from February 2014 to November 2021 was conducted. A total of 39 patients who responded to wait-and-watch management (cases) and 24 nonresponders (controls) matched for age, sex, height, weight, MGS-GCS (Markwalder grading scale and Glasgow Coma Scale), and bilateral hematoma were included. Demographics, blood cell counts, serum biochemical levels, imaging data, and relevant clinical features at baseline were collected. Significant differences between cases and controls were found in the hematoma volume, ability to urinate, maximal thickness of the hematoma, and hypodensity of the hematoma in univariate analysis. Hypodense hematoma and hematoma volume were independently associated with the outcome in multivariate analysis. Combining these independently influencing factors revealed an area under the receiver operator characteristic curve of 0.741 (95% CI: 0.609-0.874, sensitivity = 0.783, specificity = 0.667). These findings may contribute to the early detection of patients with moderate CSDH who may respond to wait-and-watch strategies. Although wait-and-watch tactics could work sometimes, medical interventions, including drug treatment, should be recommended in the clinic.

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“…Dependiendo del grado de herniación, una o ambas arterias pericallosas pueden estar comprimidas, causando paraparesia. La herniación transtentorial o uncal típicamente resulta de una masa expansiva en la fosa media o temporal 17 . En la hernia del uncus, esta estructura se hernia a través del borde libre de la tienda del cerebelo, resultando en la compresión del tercer nervio craneal homolateral y el pedúnculo cerebral, con hemiparesia contralateral 16 .…”

Section: Síndromes De Herniaciónunclassified

Hipertensión intracraneal traumática refractaria: el papel de la craniectomía descompresiva

Moscote-Salazar¹,

Alvis-Miranda²,

Ramos-Villegas³

et al. 2019

CIRU

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El trauma craneoencefálico, según la Organización Mundial de la salud, se estima que para el año 2020 será la tercera causa de morbimortalidad en el mundo. La hipertensión intracraneal refractaria al manejo médico es la causante de la mayor mortalidad en esta población de pacientes. Existen diversas medidas para el control de la hipertensión intracraneal, entre ellas las quirúrgicas. La craniectomía descompresiva ha sido utilizada sistemáticamente para tratar la hipertensión intracraneal secundaria al infarto cerebral, la hemorragia subaracnoidea, la hemorragia intracerebral y el trauma. Se hace una revisión de la literatura para describir los mecanismos fisiopatológicos de la lesión cerebral traumática, así como también los tipos y las indicaciones de este procedimiento.

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Efficacy of Reinforced Restriction of Physical Activity on Chronic Subdural Hematoma: Prospective Pilot Study

Cited by 8 publications

References 16 publications

Management of spontaneous cerebrospinal fluid hypovolemia-associated massive chronic subdural hematoma with reinforced restriction of physical activity: report of three cases

Management of spontaneous cerebrospinal fluid hypovolemia-associated massive chronic subdural hematoma with reinforced restriction of physical activity: report of three cases

Factors Influencing Wait and Watch Management for Primary Chronic Subdural Hematoma: A Retrospective Case–control Study

Hipertensión intracraneal traumática refractaria: el papel de la craniectomía descompresiva

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