Letter to the Editor Regarding “Twist Drill Procedure for Chronic Subdural Hematoma Evacuation—An Analysis of Predictors for Treatment Success”

Umana, Giuseppe Emmanuele; Chiriatti, Stefano; Fricia, Marco; Alberio, Nicola; Cicero, Salvatore; Nicoletti, Giovanni Federico; Spitaleri, Angelo; Scalia, Gianluca

doi:10.1016/j.wneu.2020.04.061

Cited by 15 publications

(4 citation statements)

References 3 publications

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“…In the literature, TDC has a low complication rate. [43][44][45][46][47] It probably mitigates the risk of overdrainage, which reduces the risk of RICH after cSDH evacuation.…”

Section: Discussionmentioning

confidence: 99%

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

Umana

Salvati

Fricia

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Background Remote intracerebral hemorrhage (RICH) is a severe complication following chronic subdural hematoma (cSDH) drainage, and only case reports and small case series have been reported to date. The authors present an emblematic patient affected by RICH following cSDH drainage. A systematic review of the literature on diagnosis and management of patients affected by RICH following cSDH evacuation has also been performed. Methods A literature search according to the PRISMA statement was conducted using PubMed and Scopus databases with the following Mesh terms: [(remote) AND (intracerebral hemorrhage or cerebral hematoma or cerebral infarction or cerebellar hemorrhage or cerebellar hematoma or cerebellar infarction) AND (chronic subdural hematoma)]. Results The literature search yielded 35 results, and 25 articles met our inclusion criteria: 22 articles were case reports and 3 were case series including three to six patients. Overall, 37 patients were included in the study. Age was reported in all 37 patients, 26 males (70.3%) and 11 females (29.7%), with a male-to-female ratio of 2.4:1. The mean age at diagnosis was 64.6 years (range: 0.25–86 years). Only in 5 cases (13.5%) did the ICH occur contralaterally to the previously drained cSDH. The rapidity of drainage can lead to several types of intracranial hemorrhages, caused by a too rapid change in the cerebral blood flow (CBF) and/or tears of bridging veins. The average time interval between cSDH drainage and neurologic deterioration was 71.05 hours (range: 0–192 hours). Conclusions RICH following cSDH represents a rare occurrence and a serious complication, associated with elevated morbidity. Careful monitoring of drain speed after cSDH evacuation surgery is recommended, and minimally invasive techniques such as twist drill craniostomy are suggested, especially for massive cSDHs.

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“…In the literature, TDC has a low complication rate. [43][44][45][46][47] It probably mitigates the risk of overdrainage, which reduces the risk of RICH after cSDH evacuation.…”

Section: Discussionmentioning

confidence: 99%

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

Umana

Salvati

Fricia

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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“…[4,6,16,22] Finally, postsurgical epilepsy with cranial shaking may lead to excessive traction and rupture of some bridging veins (already under tension and stretching due to such an important cortical atrophy), favoring blood diffusion to the subarachnoid space, through a previous arachnoid breach, irritating the cortex and self-maintaining epileptic events. e surgical procedure should be performed simultaneously and slowly with mini-craniectomies or through minimally invasive technique [20,21] and special attention should be paid to slow and controlled drainage to allow to reach the desired reduction of liquor pressure onto the gyri, avoiding risks of complications.…”

Section: Ftd and Hygromasmentioning

confidence: 99%

Bilateral post-traumatic hygromas in patient with frontotemporal dementia

Scalia

Marrone

Costanzo

et al. 2022

Surgical Neurology International

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Background: Frontotemporal dementia (FTD) is a highly disabling neurologic disorder characterized by behavioral alterations and movement disorders, involving patients with a mean age of 58 years. We present a unique case of a patient suffering from FTD who developed post traumatic bilateral hygromas. Case Description: A 52-year-old male patient, with an history of head trauma 3 months before, was admitted to our department for recurrent motor seizures. Anamnesis was positive for FTD with severe frontal syndrome. Brain computed tomography and magnetic resonance imaging (MRI) showed the typical “knife-blade” appearance of the cortical atrophy associated to bilateral hemispheric hygromas exerting mild mass effect. Brain MRI showed the signs of the cortical and “anti-cortical” vein. The two subdural collections were evacuated through two bilateral burr holes and controlled drainage. Despite anti-epileptic drugs therapy, in the early postoperative period, the patient presented further tonic-clonic seizures. The patient showed progressive recovery and was transferred to the neurorehabilitation center. After 6-month follow-up, he completely recovered. Conclusion: In FTD, severe cortical atrophy leads to space increase between arachnoid and pia mater that could affect the anatomical integrity especially after trauma, with possible development of hygromas. The coexistence of radiological findings of the cortical vein and sign of the “anti-cortical” vein can make difficult an exact differential diagnosis between a primitive hygroma and a Virchow hygroma from resorption of previous blood collection. Surgical treatment may be indicated in selected patients, but it is burdened by higher postoperative risks compared to the general population.

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“…[ 16 17 18 19 ] In the end, the most common pathology of modern times of neurosurgery, the surgical evacuation of chronic subdural hematomas, experienced a progressive reduction of invasively shifting from craniotomy to burr hole or to the twist drill craniostomy. [ 20 21 22 ] In consideration of the present study and based on our institutional experience, we think that the MIS technique must be advocated and powered by technological innovations. Experienced surgeons should support younger colleagues in using approaches with reduced invasiveness.…”

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confidence: 93%

Letter to the editor regarding “lumbar interbody fusion: Techniques, pearls and pitfalls”

Tomasi

Winkler

2021

Asian J Neurosurg

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Letter to the Editor Regarding “Twist Drill Procedure for Chronic Subdural Hematoma Evacuation—An Analysis of Predictors for Treatment Success”

Cited by 15 publications

References 3 publications

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

Bilateral post-traumatic hygromas in patient with frontotemporal dementia

Letter to the editor regarding “lumbar interbody fusion: Techniques, pearls and pitfalls”

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