BMC Surgery | |
Epidemiological characteristics of 778 patients who underwent surgical drainage of chronic subdural hematomas in Brasília, Brazil | |
Iruena M Kessler1  Nelson G Freire Neto1  Igor BC Borges3  Cléciton B Tavares3  Laise FS Brandão2  Emerson B Sousa1  | |
[1] Department of Medicine, University of Brasília, Brasília, Brazil;Department of Pós-graduação em Gerontologia, Universidade Católica de Brasília, Brasília, Brazil;Service of Neurosurgery at the Hospital de Base do Distrito Federal, Brasília, Brazil | |
关键词: Brazil; Epidemiology; Craniotomy; Burr hole; Recurrence; Surgery; Outcome; Chronic subdural hematoma; | |
Others : 1123340 DOI : 10.1186/1471-2482-13-5 |
|
received in 2012-08-04, accepted in 2013-02-13, 发布年份 2013 | |
【 摘 要 】
Background
Chronic subdural hematomas (CSDHs) are common in neurosurgical practice. There are no publications that report large series of the epidemiological characteristics of this pathology in Brazil. The purpose is to describe a large series of surgical cases and analyze the epidemiological and clinical characteristics.
Methods
We retrospectively analyzed patients with CSDH admitted into Neurosurgical Services at the Hospital de Base do Distrito Federal, Brasília, Brazil from 2006 to 2011. Age, sex, clinical feature, etiology, surgical procedure, side, clinical outcome, and recurrence were reviewed. Statistical tests were used to analyze data, and P < 0.05 was considered statistically significant.
Results
The series included 778 patients. There were 643 (82.6%) male patients with a mean age of 64.3 ± 15.9 (range, 14–93) years. The principal symptom was headache (58.9%). The most frequent origin was a fall (282 cases, 36.2%), but the origin remained unclear in 281 (36.1%) patients. Mild head injury occurred in 540 (69.4%) cases. Burr holes with drainage were used as the surgical procedure in 96.5% patients, and 687 (88.3%) patients had a positive outcome. Mortality was 0%. Recurrence was observed in 42 cases.
Conclusions
The occurrence of CSDHs is more common in elderly men. Treatment with burr holes and drainage is a simple and safe method for treatment. In our experience, CSDH presents decreased morbidity and mortality.
【 授权许可】
2013 Sousa et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150216031017674.pdf | 473KB | download | |
Figure 5. | 48KB | Image | download |
Figure 4. | 19KB | Image | download |
Figure 3. | 34KB | Image | download |
Figure 2. | 26KB | Image | download |
Figure 1. | 72KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
Figure 5.
【 参考文献 】
- [1]Markwalder TM: Chronic subdural hematomas: a review. J Neurosurg 1981, 54:637-645.
- [2]Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, DeRosa PL, Anderson K, Sussman E, Carpenter A, Connolly ES Jr: The surgical management of chronic subdural hematoma. Neurosurg Rev 2012, 35(2):155-169.
- [3]Gelabert-González M, Iglesias-Pais M, García-Allut A, Martínez-Rumbo R: Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg 2005, 107(3):223-229.
- [4]Antunes Filho GD, Alliez J, Eva L, Reynier Y, Alliez B: Análise da cirurgia do hematoma subdural crônico em cem pacientes idosos [Analysis of the surgical treatment of chronic subdural hematoma in 100 elderly patients]. Arq Brasileiro Neurocirurgia 2006, 25(4):156-160.
- [5]Yasuda CL, Morita ME, Nishimori FY, Yasuda AM, Alves HL: Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma [Chronic subdural hematoma: study of 161 patients and the relationship with coagulation abnormalities]. Arq Neuropsiquiatr 2003, 61(4):1011-1014.
- [6]Salomão JF, Leibinger RD, Lynch JC: Hematoma subdural crônico: tratamento cirúrgico e resultados em 96 pacientes [Chronic subdural hematoma: surgical treatment and results in 96 patients]. Arq Neuropsiquiatr 1990, 48(1):91-96.
- [7]Asghar M, Adhiyaman V, Greenway MW, Bhowmick BK, Bates A: Chronic subdural haematoma in the elderly: a North Wales experience. J R Soc Med 2002, 95(6):290-292.
- [8]Haines DE, Harkey HL, al-Mefty O: The “subdural” space: a new look at an outdated concept. Neurosurgery 1993, 32:111-120.
- [9]Spallone A, Giuffrè R, Gagliardi FM, Vagnozzi R: Chronic subdural hematoma in extremely aged patients. Eur Neurol 1989, 29:18-22.
- [10]Gurelik M, Aslan A, Gurelik B, Ozum U, Karadag O, Kars HZ: A safe and effective method for treatment of chronic subdural haematoma. Can J Neurol Sci 2007, 34:84-87.
- [11]Markwalder TM, Steinsiepe KF, Rohner M, Reichenbach W, Markwalder H: The course of chronic subdural hematoma after burr-hole craniostomy and closed-system drainage. J Neurosurg 1981, 55(3):390-396.
- [12]Nomura S, Kashiwagi S, Fujisawa H, Ito H, Nakamura K: Characterization of local hyperfibrinolysis in chronic subdural hematomas by SDS-PAGE and immunoblot. J Neurosurg 1994, 81:910-913.
- [13]Mori K, Maeda M: Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 2001, 41:371-381.
- [14]Ramachandran R, Hegde T: Chronic subdural hematomas: causes of morbidity and mortality. Surg Neurol 2007, 67(4):367-373.
- [15]Baechli H, Nordmann A, Bucher HC, Gratzl O: Demographics and prevalent risk factors of chronic subdural haematoma: results of a large single-center cohort study. Neurosurg Rev 2004, 27(4):263-266.
- [16]Misra M, Salazar JL, Bloom DM: Subdural-peritoneal shunt: treatment for bilateral chronic subdural hematoma. Surg Neurol 1996, 46:378-383.
- [17]Talbot LA, Musiol RJ, Witham EK, Metter EJ: Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health 2005, 5:86. BioMed Central Full Text
- [18]Hanley JP: Warfarin reversal. J Clin Pathol 2004, 57(11):1132-1139.
- [19]Rust T, Kiemer N, Erasmus A: Chronic subdural haematomas and anticoagulation or anti-thrombotic therapy. J Clin Neurosci 2006, 13(8):823-827.
- [20]Nakajima H, Yasui T, Nishikawa M, Kishi H, Kan M: The role of postoperative patient posture in the recurrence of chronic subdural hematoma: a prospective randomized trial. Surg Neurol 2002, 58:385-387.
- [21]Williams GR, Baskaya MK, Menendez J, Polin R, Willis B, Nanda A: Burr-hole versus twist-drill drainage for the evacuation of chronic subdural haematoma: a comparison of clinical results. J Clin Neurosci 2001, 8(6):551-554.
- [22]Santarius T, Lawton R, Kirkpatrick PJ, Hutchinson PJ: The management of primary chronic subdural haematoma: a questionnaire survey of practice in the United Kingdom and the Republic of Ireland. Br J Neurosurg 2008, 22(4):529-534.