• Our proposed scoring system combining haematoma volume, age, and presence of septations might be useful in identifying patients at higher risk for recurrence ((Jack A, O'Kelly C, McDougall C, Max Findlay J. Predicting Recurrence after Chronic Subdural Haematoma Drainage. (neurosurgery.directory)
  • Between April 2006 and March 2010, a total of 18 patients undergoing unilateral burr hole drainage for B-CSDH took part in a controlled clinical study. (scirp.org)
  • M. Muramatsu, T. Yoshikawa and K. Hanabusa, "Effectiveness of kampo medicine gorei-san-ryo for chronic subdural hematoma in very elderly patients," No Shinkei Geka, Vol. 33, No. 10, 2005, pp. 965-969. (scirp.org)
  • T. H. Tsai, A. S. Lieu, S. L. Hwang, T. Y. Huang and Y. F. Hwang, "A comparative study of the patients with bilateral or unilateral chronic subdural hematoma: precipitating factors and postoperative outcomes," J Trauma. (scirp.org)
  • Forty-five patients who had undergone the surgery for chronic subdural hematoma were included in this study. (go.jp)
  • The purpose of this study was to clarify the criteria for initial treatment of chronic subdural hematoma (CSDH) by com-paring the backgrounds and post-treatment courses of patients who underwent drainage or middle meningeal artery (MMA) emboliza-tion for CSDH. (go.jp)
  • We performed a retrospective investigation of 23 and 21 patients who underwent drainage and MMA embolization, respec-tive-ly, performed between April 2020 and July 2022 as initial treatment for unilateral CSDH. (go.jp)
  • There was no significant difference in median pre-operative MGS score (1 vs 1) or mean maximum hematoma diameter (18 vs 19 mm) in the 17 patients who showed resolution of CSDH by MMA embolization alone or in the 4 patients who required additional drain-age. (go.jp)
  • Many studies have created grading systems to identify patients at high risk of CSDH recurrence after the initial surgery. (surgicalneurologyint.com)
  • A single-center Puerto Rican population-based retrospective analysis was performed on consecutive patients treated for a CSDH at a designated institution from July 1, 2017 to December 31, 2019. (surgicalneurologyint.com)
  • Surgical considerations are germane because the percentage of patients with CSDH recurrence after initial surgery is relatively high (3-30% of cases). (surgicalneurologyint.com)
  • Head trauma is the most important risk factor for the development of CSDH, with 50-80% of patients in large studies having a history of head trauma before presentation. (surgicalneurologyint.com)
  • Chronic subdural haematoma (cSDH), one of the most common neurosurgical entities, occurs typically in elderly patients. (unibas.ch)
  • In symptomatic patients who are not worsening or in a comatose state, oral steroid treatment might be an alternative to surgery (type C recommendation). (unibas.ch)
  • Patients presenting without paresis can be treated with a platelet activating factor receptor antagonist (type C recommendation), since they seem to promote resolution of the haematoma, especially in patients with hygromas or low-density haematomas on computed tomography. (unibas.ch)
  • Lastly, atorvastatin seems to be a safe option for the conservative treatment of asymptomatic or mildly symptomatic cSDH patients (type C recommendation). (unibas.ch)
  • Methods : Between the years 2005 and 2009, 331 consecutive patients with CSDHs treated with surgery were included in this study. (neurosurgery.directory)
  • A pilot study found that perioperative middle meningeal artery (MMA) embolization could be offered as the least invasive and most effectual means of treatment for patients with 1 or more recurrences of intractable chronic subdural hematoma (CSDH). (medscape.com)
  • Burr hole craniostomy (BHC) surgery is commonly performed in symptomatic patients, while pharmacological and conservative approaches also demonstrate potential efficacy in managing CSDH. (dshr.one)
  • The CSDH registry is a multicenter, prospective cohort study observing CSDH patients to assess their characteristics, treatment, and outcome. (dshr.one)
  • Study population: all adult patients diagnosed with CSDH. (dshr.one)
  • We wish to extend this evidence in a study that aims to determine the efficacy and safety of atorvastatin combined with low-dose dexamethasone in patients with CSDH. (researchsquare.com)
  • The second ATorvastatin On Chronic subdural Hematoma (ATOCH-II) study is a multi-center, randomized, placebo-controlled, double blind trial which aims to enroll 240 adult patients with a conservative therapeutic indication for CSDH, randomly allocated to standard treatment with atorvastatin 20 mg combined with low-dose dexamethasone (or matching placebos) daily for 28 days, and with 152 days of follow-up. (researchsquare.com)
  • 1, 2 Evacuation of CSDH through twist-drill or bur-hole craniotomy remains the main form of treatment for symptomatic patients, 3 but surgery is associated with high risks of operative complications and recurrence. (researchsquare.com)
  • 19-22 We therefore initiated the second Atorvastatin combined with dexamethasone in Chronic subdural Haematoma (ATOCH-II) trial to determine the efficacy and safety of dexamethasone combined with low-dose atorvastatin in patients with CSDH. (researchsquare.com)
  • The primary aim of ATOCH-II is to determine whether the combination of low-dose atorvastatin and low-dose dexamethasone is superior to low-dose atorvastatin alone on the composite outcome of haematoma volume, transition to surgery, and death at 28 days in patients with CSDH. (researchsquare.com)
  • Chronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. (jkns.or.kr)
  • A retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. (jkns.or.kr)
  • Elderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. (jkns.or.kr)
  • As the prevalence of cardiovascular disease (CVD) increases with global aging, the number of CSDH patients using antithrombotic agents (AT) is gradually increasing. (jkns.or.kr)
  • In paper III, we compared 314 Ethiopian and 284 Norwegian patients operated for chronic subdural hematoma (CSDH). (uib.no)
  • In paper III, we found similar surgical routines in Ethiopia and Norway, but Ethiopian CSDH patients were younger, had fewer comorbidities, rarely used anticoagulants/antiplatelets, infrequently underwent postoperative imaging, and had less reoperations and medical complications. (uib.no)
  • Introduction Chronic subdural haematoma (cSDH) tends to occur in older patients, often with significant comorbidity. (bmj.com)
  • We assessed differences in postsurgical complication rates in patients undergoing the most common types of neurostimulation surgery. (shengsci.com)
  • The comparison FA ratios before and after burr-hole craniotomy in 23 patients with CSDH. (ajnr.org)
  • Between March 2018 and November 2022, 41 patients who experienced intraoperative high - flow CSF leakage following endoscopic endonasal surgery at two independent tertiary institution s were enrolled. (neurosurgery.directory)
  • abstract: INTRODUCTION:Bicompartmental Supra plus Infratentorial Extra Dural Hematoma (SIEDH) is an uncommon yet important category of Extradural Hematoma (EDH) straddling the transverse sinus. (shengsci.com)
  • The aim of this retrospective study was to investigate the efficacy of saireito for bilateral chronic subdural hematomas (B-CSDH). (scirp.org)
  • Pneumocephalus has also been shown to follow neurosurgical procedures such as deep brain stimulation and hematoma evacuation (e.g., chronic subdural hematoma), where while seemingly innocuous to the patient, may cause brain shift, subsequent stereotactic inaccuracy, and even another surgical intervention. (wikipedia.org)
  • Neurosurgical and Perioperative Management of Chronic Subdural Hematoma. (zonmw.nl)
  • Chronic subdural haematoma (CSDH) is a common condition in the elderly that often requires neurosurgical management. (researchsquare.com)
  • Design, setting and participants Single-centre, retrospective cohort of 530 cases of cSDH (2014-2019) surgically evacuated under general anaesthesia at a neurosciences centre in Cambridge, UK. (bmj.com)
  • Surgical outcomes of Supra- Infra Tentorial Extradural Hematoma (SIEDH): A retrospective study from a single institution. (shengsci.com)
  • Chronic subdural hematoma (CSDH) represents one of the most common forms of intracranial haemorrhage, causing a variety of diagnostic and therapeutic challenges as rates increase in ageing populations and increased use of antithrombotic agents. (researchsquare.com)
  • When septations are clearly visible within a CSDH, craniotomy might be more suitable as a primary procedure as it allows greater access to a septated subdural collection. (neurosurgery.directory)
  • A 10-point grading scale for CSDH recurrence was developed with four components: preoperative midline shift (≤1 and >1 cm), laterality (bilateral, unilateral-right, and unilateral-left), size of postoperative subdural space (≤1.6 and >1.6 cm), and pneumocephalus (present or absent). (surgicalneurologyint.com)
  • Technique s to prevent postoperative cerebrospinal fluid fistula remain controversial in transsphenoidal surgery . (neurosurgery.directory)
  • Primary closure of the fistula using the VCS was an effective strategy to prevent postoperative CSF leakage in transsphenoidal surgery. (neurosurgery.directory)
  • There was no significant difference between the drainage and embolization groups in terms of age (78 vs 76 years), gender, lateral-ity of lesion, maximum diameter of hematoma (21 vs 19 mm), pretreatment Markwalder grading system (MGS) score (1 vs 1), or length of hospital stay (5 vs 17 days) between the groups. (go.jp)
  • Univariate and multivariate analyses were performed searching for risk factors of increased post-operative haematoma volume and haematoma recurrence requiring repeat drainage. (neurosurgery.directory)
  • Conclusion: Septations within CSDHs are associated with larger post-operative residual haematoma collections requiring repeat drainage. (neurosurgery.directory)
  • M. Miyagami and Y. Kagawa, "Effectiveness of Kampo medicine Gorei-San for chronic subdural hematoma," No Shinkei Geka, Vol. 37, No. 8, 2009, pp. 765-770. (scirp.org)
  • Impaired angiogenesis and inflammation of the surrounding neomembrane may be important in the pathophysiology of CSDH, promoting the slow expansion of blood from immature 'leaky' vessels after trauma. (researchsquare.com)
  • However, CSDH is a complex disease with diverse pathophysiology, not just traumatic causes. (jkns.or.kr)
  • Background: In this study, we propose a butterfly needle tap and suction (BTS) technique for recurrent chronic subdural hematoma (CSDH) as an alternative to reoperation with burr hole craniostomy (BHC) and investigate its efficacy and safety. (nagoya-u.ac.jp)
  • The procedure involves percutaneous puncture through the burr hole created during the previous surgery and subsequent hematoma evacuation using a butterfly needle. (nagoya-u.ac.jp)
  • This aims to prevent progression of CSDH or to reduce the bleeding tendency during surgery, even though burr hole trephination (BHT) is a simple procedure with low bleeding risk, unlike other cranial surgeries. (jkns.or.kr)
  • For small CSDH, evidence has emerged that statins may reduce haematoma volume and improve outcomes, presumably by reducing local inflammation and promoting vascular repair. (researchsquare.com)
  • Secondary outcomes include functional outcome on the modified Rankin scale (mRS) and modified Barthel Index at 28 days, surgical transition, and reduction in haematoma volumes at 14, 28 and 90 days. (researchsquare.com)
  • 15 The positive results of atorvastatin 20 mg daily significantly reduced haematoma volume and improving clinical outcomes 15 has had a major impact on clinical practice in China, with this medical treatment being widely adopted for both primary conservative and adjunctive post-surgical management of CSDH. (researchsquare.com)
  • Indication-based analysis of patient outcomes following deep brain stimulation surgery. (shengsci.com)
  • This CSDH grading scale has implications for Puerto Rico and the general population as the elderly population increases worldwide. (surgicalneurologyint.com)
  • T. F. Sun, R. Boet and W. S.Poon, "Non-surgical primary treatment of chronic subdural haematoma: Preliminary results of using dexamethasone," B. J Neurosurg, Vol.19, No. 4, 2005, pp. 327-333. (scirp.org)
  • This multi-centre clinical trial aims to provide high-quality evidence on the efficacy and safety of the combined treatment of atorvastatin and low-dose dexamethasone to reduce inflammation and enhance angiogenesis in CSDH. (researchsquare.com)
  • 13 Dexamethasone had shown some effect on CSDH, but it is also complicated by adverse effects, particularly at high dose. (researchsquare.com)
  • After unilateral surgery for B-CSDH, saireito administration may prevent symptomatic deterioration of a contralateral low-density CSDH, preempting subsequent surgery. (scirp.org)
  • Severe movement disorders that don't respond to a high dose of medications may benefit from surgery -Deep Brain Stimulation (pacemaker for the brain) or Lesioning (permanent destruction of the part of the nucleus using radiofrequency energy delivered through a microelectrode). (medicahospitals.in)
  • Chronic subdural hematoma (CSDH) occurs frequently in the elderly and is thought to be related to trauma and to use of drugs such as antiplatelet agents (AP) or anticoagulants (AC) [ 8 , 20 ]. (jkns.or.kr)
  • 4 , 7 , 14 , 19 , 20 , 31 ] CSDH is most common among the elderly population, and the incidence of CSDH increases with age (among those older than 65 years, 8-58 individuals/100,000 are affected). (surgicalneurologyint.com)
  • 33 ] The incidence of CSDH and the associated mortality rate is expected to increase as the elderly population grows. (surgicalneurologyint.com)
  • The common neurological disorders in elderly involving the brain in old age are Stroke, Dementia (Alzheimer's disease being the most common cause), Parkinson's Disease (PD), Normal Pressure Hydrocephalus (NPH), Subdural Haematoma (SDH), Delirium due to low sodium or hyponatraemia (Dyselectrolytaemia). (medicahospitals.in)
  • Chronic subdural hematoma (CSDH) is a common neurological disease with an increasing incidence among the elderly. (dshr.one)
  • Neurological Surgery (in Japanese). (wikipedia.org)
  • Dr. Tene Cage is a Clinical Associate Professor of Neurological Surgery at Stanford University. (stanford.edu)
  • Dr. Cage is Board Certified by the American Board of Neurological Surgery (ABNS). (stanford.edu)
  • She then went on to complete her medical school education and Neurological Surgery residency training at the University of California San Francisco (UCSF) School of Medicine. (stanford.edu)
  • During residency, she was awarded the Exceptional Physician Award from UCSF Medical Center and the Howard Nafzigger Award from the UCSF Department of Neurological Surgery for outstanding patient care. (stanford.edu)
  • Her research has been recognized with the Lucien J. Rubenstein Memorial Award from the American Brain Tumor Association, the Young Investigator Award from the Pediatric Brain Tumor Foundation, and the Best Basic Science Research Paper Award from UCSF Neurological Surgery residency program. (stanford.edu)
  • 7, 9 The pleiotropic effects of statins on inflammation and endothelial progenitor cell activity, 10-14 which may promote haematoma reabsorption, was recently tested in the ATorvastatin On Chronic subdural Hematoma (ATOCH) study, a multicenter double-blind placebo-controlled randomised trial in China. (researchsquare.com)
  • AP prescription did not significantly delay surgery ( p =0.318), but AC prescription led to a significant increase in the time interval from admission to operation ( p =0.048). (jkns.or.kr)
  • FA ratios are significantly increased after surgery (Wilcoxon signed rank test, P = .0004). (ajnr.org)
  • Increased fibrinolytic activity at the site of the hema-toma membrane has been reported to be involved in the patho-genesis of chronic subdural hematoma. (go.jp)
  • On the other hand, just only hematomas were examined in this study, and fibrinolytic activity alleged to have in the hematoma membrane was not taken into consideration. (go.jp)
  • To eliminate the arterial supply of the external membrane of CSDH, 2 branches of the MMA were selected and occluded by injection of polyvinyl alcohol particles. (medscape.com)
  • However, it seems that there are no clear clinical or radiological signs indicating whether the cSDH will resolve spontaneously or not (type C recommendation). (unibas.ch)
  • H. Fujisawa, S. Nomura, E. Tsuchida and H. Ito, "Serum protein exudation in chronic subdural haematomas: a mechanism for haematoma enlargement? (scirp.org)
  • In conclusion, our knowledge of the conservative treatment modalities for cSDH is sparse and based on small case series and low grade evidence. (unibas.ch)
  • We provide a systematic review of studies analysing the conservative treatment options and the natural history of cSDH. (unibas.ch)
  • Monitoring of complications after endoscopic skull base surgery is necessary in order to standardize protocols of management and improve our surgical techniques. (neurosurgery.directory)
  • The primary outcome is a composite good outcome defined by any reduction from baseline in haematoma volume and survival free of surgery at 28 days. (researchsquare.com)
  • Surgery is usually the treatment of choice, but conservative treatment may be a good alternative in some situations. (unibas.ch)
  • Studies evaluating the natural history and conservative treatment modalities of cSDH remain sparse and are predominantly of low level of evidence. (unibas.ch)
  • Randomised controlled trials are currently underway, and will hopefully provide us with good evidence for or against the conservative treat-ment of cSDH. (unibas.ch)
  • J. L. Voelker, "Nonoperative treatment of chronic subdural hematoma," Neurosurg Clin. (scirp.org)
  • Regarding treatment, the addition of chemotherapy was the most common adjunct to the standard management of surgery and radiotherapy. (bvsalud.org)
  • There is currently no consensus on the optimal treatment of CSDH. (dshr.one)
  • NeoCast's promising characteristics are expected to have utility across additional neurovascular applications where deep vessel penetration is desired, including the treatment of chronic subdural hematoma (cSDH) and hypervascular spinal tumors. (myhealthyself.com)
  • Angiotensin converting-enzyme inhibitors were evaluated only as adjuvant therapy to surgery, and their effect on the rate of recurrence remains debatable. (unibas.ch)
  • There exists considerable international, national, and inter-hospital diversity in the management of CSDH. (dshr.one)
  • To clarify the mechanism of chronic subdural hema-toma, the hematomas taken intraoperatively were mixed with the fresh patient's blood and observed the clot formation. (go.jp)
  • CSDH is one of the most common conditions neurosurgeons treat, estimated to occur in 3.4-5 individuals/100,000. (surgicalneurologyint.com)
  • Results: In paper I, we found that the most common cause of TBI was assault, while depressed skull fracture (DSF) and epidural hematoma (EDH) were the leading injuries. (uib.no)
  • Efforts are made by neurosurgeons to reduce pneumocephalus volume during surgery, and thus, subsequent brain shift. (wikipedia.org)
  • Cerebrospinal fluid leakage after endoscopic skull base surgery remains a challenge despite multilayer reconstruction including nasoseptal flap (NSF) has become a standard technique . (neurosurgery.directory)
  • The remainder, including eight saireito-treated hematomas, resolved without further surgery, generally within eight weeks of the surgical side procedure. (scirp.org)