Regional Cerebral Blood Flow in Patients With Chronic Subdural Hematomas

Brodersen, P; Gjerris, F.

doi:10.1111/j.1600-0404.1975.tb07604.x

Cited by 50 publications

(19 citation statements)

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“…Pathophysiologic mechanisms, though requiring further elucidation, are responsible in the occurrence of seizures after CSDH, including (1) development of a space-occupying lesion with mass effect, inducing reduced cerebral blood flow that may be involved in immediate seizures [22]; (2) a variety of surgical techniques or unpredicted brain insults may be present individually or together, which may provoke early seizures [5]; and (3) late-onset seizures can theoretically be due to gliosis from previous cortical injury or the presence of hematoma capsules [18].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcome of Seizures After Chronic Subdural Hematoma

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcome of Seizures After Chronic Subdural Hematoma

et al. 2011

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“…Similarly, the pathophysiology of epileptogenesis in these patients is incompletely known, but is thought to be biphasic, with 1) early and 2) late post traumatic epilepsy (PTE) (Agrawal et al 2006). One hypothesis states that in the immediate peri-injury period, brain swelling, cerebral ischemia and the release of excitatory amino acids and other toxins precipitate neuronal damage (Agrawal et al 2006; Brodersen and Gjerris 1975). Comparatively, in the late post injury period, an excess of extracorpuscular hemoglobin facilitates the creation of cytotoxic hydroxyls, reactive oxygen species moieties and glutamate accumulation (Payan et al 1970).…”

Section: Introductionmentioning

confidence: 99%

The epidemiology, risk factors, and impact on hospital mortality of status epilepticus after subdural hematoma in the United States

et al. 2014

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IntroductionSubdural hematoma (SDH) is a well described risk factor in the development of Status Epilepticus (SE), however the epidemiology of SE after SDH is unknown. In this study, we sought to determine the epidemiology of SE, the prevalence of risk factors, and impact on hospital mortality using a large administrative dataset.MethodsData was derived from the Nationwide Inpatient Sample from 1988 through 2011. We queried the NIS database for patients older than 18 years, with a diagnosis of SDH and SE. Diagnoses were defined by ICD 9 CM codes 432.1, 852.2, 852.3 and 345.3 for SE. Adjusted incidence rates of admission and prevalence proportions were calculated. Multivariate logistic models were then fitted to assess for the impact of status epilepticus on hospital mortality.ResultsOver the 23-year period, we identified more than 1,583,255 admissions with a diagnosis of SDH. The prevalence of SE in this cohort was 0.5% (7,421 admissions). The population adjusted incidence rate of admissions of SDH increased from 13/100,000 in 1988 to 38/100,000 in 2011. The prevalence of SE in SDH, increased from 0.5% in 1988 to 0.7% in 2011. In hospital mortality of patients with SDH and without SE decreased from 17.9% to 10.3% while in hospital mortality of patients with SDH and SE did not statistically change. Mortality increased over the same period (2.3/100,000 in 1988 to 3.9/100.000 in 2011) and the diagnosis of SE increased mortality in this cohort (OR 2.17, p < 0.0001). The risk of SE remained stable throughout the study period, but was higher among older patients, blacks, and in those with respiratory, metabolic, hematological, and renal system dysfunction.ConclusionOur study demonstrates that the incidence of admissions of SDH is increasing in the United States. Despite a decline in the overall SDH related mortality, SE increased the risk of in-hospital death in patients with a primary diagnosis of SDH.

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“…Aspects of the epidemiology, histology, and pathophysiology of these haematomas have been reported in several papers (Putnam and Cushing, 1925;Weir, 1971; Brodersen and Gjerris, 1975;. However, with the exception of two communications (McKissock et al, 1960;Loew and Kivelitz, 1976), relatively little attention has been paid to the clinical presentation, diagnostic investigations, and prognosis.…”

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confidence: 99%