Postoperative course after acute traumatic subdural hematoma in the elderly : Does the extent of craniotomy influence outcome?

13:18 EDT 23rd August 2014 | BioPortfolio

Summary of "Postoperative course after acute traumatic subdural hematoma in the elderly : Does the extent of craniotomy influence outcome?"


AIM:
The goal of the study was to analyze the short-term outcome after surgical treatment of acute subdural hematomas in two treatment groups in a patient population >65 years. Whether there are disadvantages from invasive treatment or whether advantages can be achieved with the less invasive treatment has not been previously examined in a prospective study.
METHODS:
A prospective, nonrandomized study of 50 patients >65 years with acute traumatic subdural hematoma was performed, comparing the short-term outcome after two different primary surgical procedures: limited craniotomy (group A, n=25) and large decompressive craniectomy (group B, n=25).
RESULTS:
There were no differences of hematoma volume, degree of midline structure shift, and time from trauma to operation between the two groups. Initial Glasgow coma scale and short-term outcome after 4 weeks measured by the Glasgow outcome score in both groups showed no significant differences.
CONCLUSION:
No significant differences between short-term outcome after limited craniotomy versus large decompressive craniectomy were found for patients >65 years, and the results indicate that decompressive craniectomy can be accepted as a surgical treatment option for acute traumatic subdural hematoma even in elderly patients.

Affiliation

Neurochirurgische Klinik, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland, chr74@gmx.de.

Journal Details

This article was published in the following journal.

Name: Zeitschrift fur Gerontologie und Geriatrie : Organ der Deutschen Gesellschaft fur Gerontologie und Geriatrie
ISSN: 1435-1269
Pages:

Links

PubMed Articles [11404 Associated PubMed Articles listed on BioPortfolio]

Spontaneously rapid resolution of acute subdural hemorrhage with severe midline shift.

Acute subdural hematoma is usually a neurological emergency that requires hematoma evacuation or close observation. However, spontaneous resolutions of an acute subdural hematoma without surgical inte...

Contralateral acute subdural hematoma occurring after evacuation of subdural hematoma with coexistent contralateral subdural hygroma.

Burr-hole craniostomy with closed-system drainage is a safe and effective method for the management of chronic subdural hematoma. However, contralateral acute subdural hematoma has been reported to be...

Acute subdural hematoma after aortic surgery: A retrospective comparative study.

Acute subdural hematoma is uncommon following open-heart surgery, but may result in increased mortality and morbidity.

Endoscopic surgery for traumatic acute subdural hematoma.

Traumatic acute subdural hematoma (ASDH) is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole end...

Intracranial subdural hematoma after spinal anesthesia for cesarean section.

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of...

Clinical Trials [4007 Associated Clinical Trials listed on BioPortfolio]

Chronic Subdural Hematoma - Reduction of Recurrence by Treatment With Angiotensin Converting Enzyme Inhibitors

The project aims at investigating if treatment with the Angiotensin Converting Enzyme inhibitor Coversyl (perindopril) for 3 months after surgery for chronic subdural hematoma will decreas...

Efficacy and Safety of Factor VIIa on Rebleeding After Surgery for Spontaneous Intracerebral Hemorrhage (ICH)

Although the role of surgical treatment is still controversial, surgical evacuation of intracerebral hematoma is a frequent practice. Rebleeding is a frequent complication in patients sub...

Comparison Study of Using Ultrasound Guidance for Hematoma Blocks vs. Traditional Approach

Will use visual analog scales to compare effectiveness of traditional hematoma block vs ultrasound guided hematoma block with regards to pain. This will be done for closed forearm fracture...

Platelet Transfusion in Acute Intracerebral Hemorrhage

- To prove whether use of antiplatelet agents results into a rapid enlargement of hematoma after onset of acute intracerebral hemorrhage. - To prove the efficacy and safety of pl...

Postoperative Blood Transfusion for Frail Elderly With Hip Fracture

Elderly with hip fractures are often fragile and discharged from hospital after few days of hospitalisation. Hip fracture surgery is often associated with blood loss, where the patient is...

Medical and Biotech [MESH] Definitions

Accumulation of blood in the SUBDURAL SPACE between the DURA MATER and the arachnoidal layer of the MENINGES. This condition primarily occurs over the surface of a CEREBRAL HEMISPHERE, but may develop in the spinal canal (HEMATOMA, SUBDURAL, SPINAL). Subdural hematoma can be classified as the acute or the chronic form, with immediate or delayed symptom onset, respectively. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status.

Accumulation of blood in the SUBDURAL SPACE with acute onset of neurological symptoms. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status.

Subdural hematoma of the SPINAL CANAL.

Accumulation of blood in the SUBDURAL SPACE over the CEREBRAL HEMISPHERE.

Accumulation of blood in the SUBDURAL SPACE with delayed onset of neurological symptoms. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status.

Search BioPortfolio: