Slippery Platelet Syndromes in Subdural Hematoma

Akins, Paul T.; Guppy, Kern H.; Sahrakar, Kamran; Hawk, Mark

doi:10.1007/s12028-010-9336-3

Cited by 13 publications

(6 citation statements)

References 19 publications

(33 reference statements)

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“…This corresponds well with previous reports of TEG-PM demonstrating reduced platelet activity in patients with TBI [45]. PFA-100 was used in 58 patients with subdural haematoma and 38% of these patients had impaired platelet function [46]. The PFA-100 was also used as a screening tool prior to elective neurosurgical procedures by Karger and colleagues who found that 15 out of 93 patients had abnormal findings [47].…”

Section: Assessment Of Platelet Functionsupporting

confidence: 86%

Point of care coagulation testing in neurosurgery

Beynon

Unterberg

Sakowitz

2015

Journal of Clinical Neuroscience

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Section: Assessment Of Platelet Functionsupporting

confidence: 86%

Point of care coagulation testing in neurosurgery

Beynon

Unterberg

Sakowitz

2015

Journal of Clinical Neuroscience

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“…In a pilot study, the degree of hematoma evacuation was !90%, 75 to 89% and 50 to 74% in 74, 20, and 5.7% of patients, respectively, with an overall 3% rebleed rate. There were reported improvements in preoperative to postoperative GCS scores (10)(11)(12)(13). 90 This device seems to be used predominantly in a lobar location.…”

Section: Surgical Managementmentioning

confidence: 98%

“…There is increasing evidence that ICH is complicated by impaired platelet function, most often as a result of antiplatelet agent (APA) ingestion, although other etiologies may exist. [10][11][12][13] As a result, platelet function is increasingly evaluated and platelet transfusions are often given in the setting of acute spontaneous ICH in an effort to promote hemostasis. There is little evidence currently to guide this practice.…”

Section: Introductionmentioning

confidence: 99%

Surgical Strategies for Spontaneous Intracerebral Hemorrhage

et al. 2016

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In recent decades, the medical and surgical treatment of intracerebral hemorrhage (ICH) have become the focus of a number of scientific investigations. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new medical and surgical treatments to facilitate improved clinical outcomes. Currently, two of the most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction. Answering these questions would support decision-making, level-of-care choices, and the global research strategy of developing biologically informed treatments. The authors review the contemporary medical management and the conventional and minimally invasive surgical approaches to spontaneous ICH, as well as discuss the scope of the problem, recent clinical trials, management issues, and relevant questions for future research. They propose the hypothesis that strategies using minimally invasive techniques, including clot aspiration with stereotactic guidance, may give better results with improved clinical outcomes compared with standard open surgical approaches. They also discuss the level of evidence for the variously known approaches.

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“…Bereits 2010 wurde eine interessante Arbeit publiziert, die an 58 Patienten mit SDH eine Thrombozytenfunktionsdiagnostik mittels des PFA-100 vornahm [57]. Bei 40 % (n = 6) der Patienten, die mit VKA behandelt waren, konnte zusätzlich eine Thrombozytenfunktionsstörung nachgewiesen werden.…”

Section: Merkeunclassified

Point-of-Care-Gerinnungsdiagnostik in der Neurochirurgie

Adam¹,

Füllenbach²,

Lindau³

et al. 2018

Anästhesiol Intensivmed Notfallmed Schmerzther

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Disorders of the coagulation system can seriously impact the clinical course and outcome of neurosurgical patients. Due to the anatomical location of the central nervous system within the closed skull, bleeding complications can lead to devastating consequences such as an increase in intracranial pressure or enlargement of intracranial hematoma. Point-of-care (POC) devices for the testing of haemostatic parameters have been implemented in various fields of medicine. Major advantages of these devices are that results are available quickly and that analysis can be performed at the bedside, directly affecting patient management. POC devices allow identification of increased bleeding tendencies and therefore may enable an assessment of hemorrhagic risks in neurosurgical patients. Although data regarding the use of POC testing in neurosurgical patients are limited, they suggest that coagulation testing and hemostatic therapy using POC devices might have beneficial effects in this patient population. This article provides an overview of the application of point-of-care coagulation testing in clinical practice in neurosurgical patients.

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Slippery Platelet Syndromes in Subdural Hematoma

Abstract: Platelet dysfunction was found in 38% of SDH patients. This finding adds to our understanding of the pathophysiology of SDH. Since platelet transfusions are indicated for platelet dysfunction accompanied by major bleeding or need for surgery, these results impact peri-operative management.

Cited by 13 publications

References 19 publications

Point of care coagulation testing in neurosurgery

Point of care coagulation testing in neurosurgery

Surgical Strategies for Spontaneous Intracerebral Hemorrhage

Point-of-Care-Gerinnungsdiagnostik in der Neurochirurgie

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