Surgical Treatment of Bilateral Chronic Subdural Hematoma

Zhuang, Yan; Jiang, Ming; Zhou, Jiahao; Li, Jun; Fang, Zhen; Chen, Zejun

doi:10.1155/2022/2823314

Cited by 3 publications

(3 citation statements)

References 36 publications

(32 reference statements)

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“…CSH arises from the rupture and hemorrhage of veins subsequent to physical injury [ 8 ]. Venous hemorrhage has a gradual progression and typically ceases through the application of intracranial pressure or the formation of a clot.…”

Section: Discussionmentioning

confidence: 99%

The Use of Adjuvant Dexamethasone in Chronic Subdural Hematoma After Surgery

Cine

2023

Cureus

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Objective: The use of oral anticoagulants in elderly patients is a predisposing factor in developing a subdural hematoma (SDH). The surgical option is often the standard approach but can be accompanied by complications. In this study, we hypothesized that dexamethasone administration after surgery would positively affect subdural change and subdural size in the second week. Materials and methods: Within the scope of this prospective research, 66 individuals who underwent surgical intervention for chronic subdural hematoma (CSH) at the neurosurgery department either as an outpatient or under emergency circumstances have been enrolled in the study. During the examination, the patients were questioned about the traumatic incident, the localization of injury, and the utilization of anticoagulant and antiplatelet medications. The Glasgow Coma Scale (GCS) was administered to all patients to assess neurological deficits. Computed tomography (CT) was utilized to determine the characteristics of the hematoma. Results: A total of 66 patients, 22 (33.3%) using and 44 (66.6%) not using dexamethasone, were included in the study. Analysis of variance (ANOVA) indicated that a statistical difference was achieved in the second week after the operation (p<0.043). During the examination of subdural dimensions after the operation and in the second postoperative week, a difference was detected between the radiological membrane and subdural dimensions. A statistically significant correlation was found between anticoagulation and the type of hematoma (p<0.025). Conclusion: Regarding the outcomes of this research, we can conclude that dexamethasone was not associated with any adverse events. Additionally, dexamethasone could leverage reoperation prevention for the elderly with various comorbidities.

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Section: Discussionmentioning

confidence: 99%

The Use of Adjuvant Dexamethasone in Chronic Subdural Hematoma After Surgery

Cine

2023

Cureus

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“…Computational Intelligence and Neuroscience has retracted the article titled "Surgical Treatment of Bilateral Chronic Subdural Hematoma" [1] due to concerns that the peer review process has been compromised. Following an investigation conducted by the Hindawi Research Integrity team [2], signifcant concerns were identifed with the peer reviewers assigned to this article; the investigation has concluded that the peer review process was compromised.…”

mentioning

confidence: 99%

“…Computational Intelligence and Neuroscience has retracted the article titled “Surgical Treatment of Bilateral Chronic Subdural Hematoma” [ 1 ] due to concerns that the peer review process has been compromised.…”

mentioning

confidence: 99%

Retracted: Surgical Treatment of Bilateral Chronic Subdural Hematoma

Neuroscience¹

2022

Computational Intelligence and Neuroscience

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Efficacy of Burrhole Craniostomy in Chronic Subdural Hematoma. A Retrospective 9-Year Study

ÖZER¹,

ŞAHİN²

2023

Middle Black Sea Journal of Health Science

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Aim: To demonstrate the effectiveness, possible complications, and difference of Burr-hole craniostomy surgical technique applied to patients diagnosed with chronic subdural hematoma from other surgical techniques. Material and Methods: The surgical techniques and postoperative clinical and radiological details of 36 patients who were operated on with the diagnosis of chronic subdural hematoma in the Neurosurgery Clinic of Ordu University Training and Research Hospital between 01.01.2013 and 15.08.2022 were retrospectively analyzed. Twenty-eight (77.7%) of the cases were male and 8 (22.3%) were female. The mean age was 70, with an age range of 54-87. Ten of the cases had a GCS of 15 (28%), 20 had a GCS of 13-14 (56%), and 6 had a GCS of 8-12. The most prominent complaints of the patients were headache and confusion. While 22 patients (61.1%) had a history of head trauma, 14 patients (38.9%) had no history of trauma. There was a history of anticoagulant or antiaggregant drug use in 9 patients (25%). In all patients in the post-op period, control brain CT was taken within the first 24 hours and compared with the pre-op CT. Again, at the end of post-op 1st, 2nd week and 1st month, control brain CT was taken for all patients and GCS was compared with pre-op scores. After determining the post-op complications, the treatment and results of these complications were examined. Results: In all patients in the post-op period, control brain CT was taken within the first 24 hours and compared with the pre-op CT. Again, at the end of post-op 1st, 2nd week and 1st month, control brain CT was taken for all patients and GCS was compared with pre-op scores. Craniotomy + membranectomy was performed in 6 patients because of residual bleeding in the post-op period and no improvement in their neurological status. One of the patients who were operated on by craniotomy died due to sepsis in the later period. One patient who was operated on with Burr-Hole developed motor dysphasia in the post-op period, and intraparenchymal hemorrhage was detected in the post-op tomography of this patient. This patient's dysphasia resolved at the end of the post-op 1 month. Although pneumocephaly developed in the post-op period in 9 patients who underwent burr-hole craniostomy, they did not require surgical treatment and were observed to be spontaneously resorbed. In addition, wound site infection developed in the post-op period in 4 patients who underwent Burr-hole craniostmia. Appropriate antibiotic therapy was given to these patients. At the end of the first week, radiological examination of 18 patients with CT showed no residual hematoma or recurrent hematoma. The radiological improvement of 10 patients was completed at the end of the 1st month and the radiological recovery of 7 patients was completed at the end of the 3rd month. Post-op clinical and radiological results of patients who underwent burr-hole craniostomy were significantly better than pre-op clinical and radiological results, and the recurrence rate was low, consistent with the literature. Conclusion: Although the drainage of chronic subdural hematoma with bur-hole craniostomy has a higher recurrence rate compared to the craniotomy method, it has a lower complication rate and is a more easily applicable surgical technique. In our study, some important points about patients who underwent burrhole craniostomy for cSDH evacuation were highlighted. It was observed that our patients who underwent burrhole craniostomy had higher reoperation rates compared to our patients who underwent craniotomy. We think that the presence of residual hematoma in the controls performed with CT in the post-op period should not be the sole criterion for re-operation. We think that CT controls are sufficient if there is improvement in the neurological status of the patient and a better GCS score in the post-op follow-up.

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Surgical Treatment of Bilateral Chronic Subdural Hematoma

Cited by 3 publications

References 36 publications

The Use of Adjuvant Dexamethasone in Chronic Subdural Hematoma After Surgery

The Use of Adjuvant Dexamethasone in Chronic Subdural Hematoma After Surgery

Retracted: Surgical Treatment of Bilateral Chronic Subdural Hematoma

Efficacy of Burrhole Craniostomy in Chronic Subdural Hematoma. A Retrospective 9-Year Study

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