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Chronic Subdural Hematomas: Epidemiology, Radiology, Hematological Parameters and Surgical Results of Cases

Yıl 2018, Cilt: 9 Sayı: 35, 121 - 127, 31.12.2018
https://doi.org/10.17944/mkutfd.423487

Öz

Aim: Chronic Subdural hematomas (CDSH) first reported in 1656 by JJ Wepfer. In 1857 CSDH was defined as Pachimenengitis hemoragyca interna. Frequency of CSDH changes with age progression. İt’s reported in literature; CDSH coexists %60-80 with minor head trauma. We aimed to present our experience in follow-up and treatment of patients with CSDH which are frequently encountered in routine neurosurgical practice. 

Materials and Methods: Cases of CSDH which were operated between January 2016- December 2017 evaluated retrospectively from Clinical Files. The patients' clinical files were evaluated retrospectively according to age, gender, personal background, complaint, use of anticoagulant, presence of head trauma, radiologic images, hematologic parameters, type of anesthesia, surgical method and recurrence rates.

Results: The study consists of total 67 cases which %20,9 (n=14) female and %79,1 (n=53) male. The ages of the cases ranged from 16 to 91 years with an average of 68,60 ± 16,45 years. The duration of hospitalization according to gender and age, the duration of hospitalization according to the presence of additional disease and the types of additional diseases seen, the duration of hospitalization according to drug use and anesthesia type (p> 0.05), between N / L and residence time (r: 0,222; p > 0.05) were not statistically significant.

Conclusions: However, it may seem so basic; Choices about Surgical techniques and type of anesthesia are effective about mortality and morbidity. Because of duration of surgery is shorter; it is shown that Surgeries performed with Sedoanalgesia and local anesthesia can be used safely especially for patients with comorbidity.

Kaynakça

  • Çelikoğlu E, İş M, Yılmaz M, Kiraz İ, Ramazanoğlu AF, Alkan B. Kronik Subdural Hematom Olgularımızın Cerrahi Sonuçları. Sinir Sistemi Cerrahisi Derg 2014;4(1):36-41.
  • 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;107:223-9.
  • Virchow R. DasHamatom de dura mater. Ver Phys-MedGesWürzb1857;7:134-42.
  • DucruetAF, Grobelny BT, Zacharia BE, HickmanZL, Derosa PL, Anderson K, et al. The surgical management of chronic subdural hematoma. NeurosurgRev2012;35:155-69.
  • Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH. Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J KoreanNeurosurgSoc2008;43:11-5.
  • FratiA, Salvati M, Mainiero F, Ippoliti F, Rocchi G, Raco A, et al. Inflammation markers and risk factors for recurrence in 35 patients with a posttraumatic chronic subdural hematoma: a prospective study. J Neuro¬surg2004;100:24-32.
  • Okada Y, Akai T, Okamoto K, Iida T, Takata H, Ii¬zuka H. A comparative study of the treatment of chronic subdural hematoma burr-hole drainage versus burr-hole irrigation. SurgNeurol2002;57:405-9.
  • Ernestus RI, Beldzinski P, Lanfermann H, Klug N. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. SurgNeurol1997;48:220-5.
  • Ziai WC, Torbey MT, Kickler TS, Oh S, Bhardwaj A, Wityk RJ. Platelet count and function in spontaneous intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2003; 12:201-6.
  • Arıkanoğlu A, Çevik MU, Uzar E, Acar A, Akıl E, Ekici F, et al. İntraserebral kanamalı hastalarda ortalama trombosit hacminin artışı. Türk Nöroloji Dergisi. 2012; 18:54-6.
  • Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyteratio as predictor of new on set atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2010; 105: 186-91.
  • Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The baseline ratio of neutrophils to lymphocytes is associated with patient prognosisin advanced gastric cancer. Oncology. 2007; 73: 215-20.
  • Nakaguchi H, Tanishima T, Yoshimasu N. Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma afte rburr-hole irrigation and closed-system drainage. J Neurosurg 2000;93:791-5.
  • Nakaguchi H, Tanishima T, Yoshimasu N. Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg2001;95:256-62.
  • Liu Y, Xia JZ, WuAH, Wang YJ. Burr-hole craniotomy treating chronic subdural hematoma: a report of 398 cases. Chin J Traumatol 2010;13:265-9.
  • Kostanian V, Choi JC, Liker MA, Go JL, Zee CS. Computed tomographic characteristics of chronic subdural hematomas. Neurosurg Clin N Am 2000;11:479-89.
  • Kamışlı S, Kamışlı Ö, Gönüllü S, Kaplan Y, Özcan C. Erken lökosit ve nötrofil yüksekliğinin serebral venöz trombozda prognostik önemi. Türk Beyin Damar Hastalıkları Dergisi 2012; 18: 39-42.
  • Tuzcu K, Davarcı I, Hakimoğlu S, Yengil E, Aras M, Sarı A, et al. Evaluatıon Of Neutrophil/Lymphocyte Ratıo And Mean Platelet Volume In Patıents Wıth Acute And Chronıc Subdural Hemorrhage. Mustafa Kemal Üniv. Tıp Derg, 2013; 4(14),23-30,
  • Mulley GP, Heptinstall S, Taylor PM, Mitchell JR. ADP- induced platelet release reaction in acute stroke. Thromb Haemost. 1983; 50: 524-6.
  • Mayda-Domac F, Misirli H, Yilmaz M. Prognostic role of mean platelet volüme and platelet count in ischemic and hemorrhagic stroke. J Stroke and Cerebrovasc Dis 2010;19: 66-72.
  • McKissock W, RichardsonA, Bloom WH. Subdural haematoma: a review of 389 cases. Lancet 1960;1: 1360-5.
  • Tabaddor K, Shulmon K. Definitive treatment of chronic subdural hematoma by twist-drill craniostomy and closed-system drainage. J Neurosurg 1977;46:220-6.
  • Okada Y, Akai T, Okamoto K, Iida T, Takata H, Ii¬zuka H. A comparative study of the treatment of chronic subdural hematoma burr-hole drainage versus burr-hole irrigation. Surg Neurol 2002;57:405-9.
  • Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J NeurolNeurosurg Psychiatry 2003;74:937-43.
  • Tuğcu B, Tanrıverdi O, Baydın S, Günaldı Ö, Ofluoğlu E, Demirgil BT. Tekrarlayan kronik subdural hematomlar önceden öngörülebilir mi? 136 olgunun retrospektif analizi. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2010;23:44-49
  • Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S. Independent predictors of recurrence of chronic subdural hematoma: results of multivariate analysis performed using a logistic regression model. J Neurosurg 2003;98:1217-1221.
  • Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S. Independent predictors for recurrence of chronic subdural hematoma: a review of 343 consecutive surgical cases. Neurosurgery 2008;63:1125-1129.
  • Lindvall P, Koskinen LO. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J ClinNeurosci 2009;16:1287-1290.
  • Stanisic M, Lund-Johansen M, Mahesparan R. Treatment of chronic subdural hematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrence. ActaNeurochir (Wien) 2005;147:1249-1256.

Kronik Subdural Hematomlar: Epidemiyoloji, Radyoloji, Hematolojik Parametreler ve Olgularımızın Cerrahi Sonuçları

Yıl 2018, Cilt: 9 Sayı: 35, 121 - 127, 31.12.2018
https://doi.org/10.17944/mkutfd.423487

Öz

Amaç: Kronik subdural hematom (KSDH) ilk defa 1656 yılında JJ Wepfer tarafından bildirilmiş, 1857 yılında Virchow tarafından Pakimenenjitis hemorajika interna olarak tanımlanmıştır. KSDH sıklığı yaşla değişmektedir. Hafif kafa travması ile birlikteliği literatürde %60-80 oranında bildirilmektedir. Bu çalışma ile rutin nöroşirurji pratiğinde sık karşılaşılan KSDH hastalarının takip ve tedavilerinde klinik deneyimimizi sunmayı amaçladık.

Gereç ve Yöntem: 2016 Ocak - 2017 Aralık tarihleri arasında KSDH tanısı ile opere edilen hastaların klinik dosyalarından kayıtlar incelendi. Hastaların klinik dosyalarından yaş, cinsiyet, özgeçmiş, geliş şikâyeti, antikoagülan kullanımı, kafa travması varlığı, radyolojik görüntüleri, hematolojik parametreleri cerrahide uygulanan anestezi şekli, cerrahi method, rekürrens oranları retrospektif olarak değerlendirildi.

Bulgular: Çalışma, hastaların %20,9’u (n=14) kadın, %79,1’i (n=53) erkek olmak üzere toplam 67 olgu ile gerçekleştirilmiştir. Olguların yaşları 16 ile 91 arasında değişmekte olup, ortalama 68,60±16,45 yıldır. Cinsiyete ve yaşa göre yatış süreleri, ek hastalık varlığı ve görülen ek hastalık türlerine göre yatış süreleri arasında, ilaç kullanımı ve anestezi şekline göre yatış süreleri arasında(p>0,05), N/L ile yatış süresi arasında (r:0,222; p>0,05) istatistiksel olarak anlamlı farklılık saptanmamıştır.

Sonuç: Cerrahi seçimler, anestezi tercihi ne kadar basit olarak görülse de mortalite ve morbiditede oldukça etkilidir. Sedoaneljezi ve lokal anestezi altında yapılan ameliyatların, cerrahi sürenin kısa olması nedeniyle özellikle komorbiditesi olan hasta grubunda güvenle tercih edilebileceğini göstermektedir.

Kaynakça

  • Çelikoğlu E, İş M, Yılmaz M, Kiraz İ, Ramazanoğlu AF, Alkan B. Kronik Subdural Hematom Olgularımızın Cerrahi Sonuçları. Sinir Sistemi Cerrahisi Derg 2014;4(1):36-41.
  • 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;107:223-9.
  • Virchow R. DasHamatom de dura mater. Ver Phys-MedGesWürzb1857;7:134-42.
  • DucruetAF, Grobelny BT, Zacharia BE, HickmanZL, Derosa PL, Anderson K, et al. The surgical management of chronic subdural hematoma. NeurosurgRev2012;35:155-69.
  • Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH. Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J KoreanNeurosurgSoc2008;43:11-5.
  • FratiA, Salvati M, Mainiero F, Ippoliti F, Rocchi G, Raco A, et al. Inflammation markers and risk factors for recurrence in 35 patients with a posttraumatic chronic subdural hematoma: a prospective study. J Neuro¬surg2004;100:24-32.
  • Okada Y, Akai T, Okamoto K, Iida T, Takata H, Ii¬zuka H. A comparative study of the treatment of chronic subdural hematoma burr-hole drainage versus burr-hole irrigation. SurgNeurol2002;57:405-9.
  • Ernestus RI, Beldzinski P, Lanfermann H, Klug N. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. SurgNeurol1997;48:220-5.
  • Ziai WC, Torbey MT, Kickler TS, Oh S, Bhardwaj A, Wityk RJ. Platelet count and function in spontaneous intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2003; 12:201-6.
  • Arıkanoğlu A, Çevik MU, Uzar E, Acar A, Akıl E, Ekici F, et al. İntraserebral kanamalı hastalarda ortalama trombosit hacminin artışı. Türk Nöroloji Dergisi. 2012; 18:54-6.
  • Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyteratio as predictor of new on set atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2010; 105: 186-91.
  • Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The baseline ratio of neutrophils to lymphocytes is associated with patient prognosisin advanced gastric cancer. Oncology. 2007; 73: 215-20.
  • Nakaguchi H, Tanishima T, Yoshimasu N. Relationship between drainage catheter location and postoperative recurrence of chronic subdural hematoma afte rburr-hole irrigation and closed-system drainage. J Neurosurg 2000;93:791-5.
  • Nakaguchi H, Tanishima T, Yoshimasu N. Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg2001;95:256-62.
  • Liu Y, Xia JZ, WuAH, Wang YJ. Burr-hole craniotomy treating chronic subdural hematoma: a report of 398 cases. Chin J Traumatol 2010;13:265-9.
  • Kostanian V, Choi JC, Liker MA, Go JL, Zee CS. Computed tomographic characteristics of chronic subdural hematomas. Neurosurg Clin N Am 2000;11:479-89.
  • Kamışlı S, Kamışlı Ö, Gönüllü S, Kaplan Y, Özcan C. Erken lökosit ve nötrofil yüksekliğinin serebral venöz trombozda prognostik önemi. Türk Beyin Damar Hastalıkları Dergisi 2012; 18: 39-42.
  • Tuzcu K, Davarcı I, Hakimoğlu S, Yengil E, Aras M, Sarı A, et al. Evaluatıon Of Neutrophil/Lymphocyte Ratıo And Mean Platelet Volume In Patıents Wıth Acute And Chronıc Subdural Hemorrhage. Mustafa Kemal Üniv. Tıp Derg, 2013; 4(14),23-30,
  • Mulley GP, Heptinstall S, Taylor PM, Mitchell JR. ADP- induced platelet release reaction in acute stroke. Thromb Haemost. 1983; 50: 524-6.
  • Mayda-Domac F, Misirli H, Yilmaz M. Prognostic role of mean platelet volüme and platelet count in ischemic and hemorrhagic stroke. J Stroke and Cerebrovasc Dis 2010;19: 66-72.
  • McKissock W, RichardsonA, Bloom WH. Subdural haematoma: a review of 389 cases. Lancet 1960;1: 1360-5.
  • Tabaddor K, Shulmon K. Definitive treatment of chronic subdural hematoma by twist-drill craniostomy and closed-system drainage. J Neurosurg 1977;46:220-6.
  • Okada Y, Akai T, Okamoto K, Iida T, Takata H, Ii¬zuka H. A comparative study of the treatment of chronic subdural hematoma burr-hole drainage versus burr-hole irrigation. Surg Neurol 2002;57:405-9.
  • Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J NeurolNeurosurg Psychiatry 2003;74:937-43.
  • Tuğcu B, Tanrıverdi O, Baydın S, Günaldı Ö, Ofluoğlu E, Demirgil BT. Tekrarlayan kronik subdural hematomlar önceden öngörülebilir mi? 136 olgunun retrospektif analizi. Düşünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2010;23:44-49
  • Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S. Independent predictors of recurrence of chronic subdural hematoma: results of multivariate analysis performed using a logistic regression model. J Neurosurg 2003;98:1217-1221.
  • Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S. Independent predictors for recurrence of chronic subdural hematoma: a review of 343 consecutive surgical cases. Neurosurgery 2008;63:1125-1129.
  • Lindvall P, Koskinen LO. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J ClinNeurosci 2009;16:1287-1290.
  • Stanisic M, Lund-Johansen M, Mahesparan R. Treatment of chronic subdural hematoma by burr-hole craniostomy in adults: influence of some factors on postoperative recurrence. ActaNeurochir (Wien) 2005;147:1249-1256.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

Okan Türk 0000-0002-9514-6891

Can Yaldız Bu kişi benim 0000-0002-9523-076X

Davut Ceylan Bu kişi benim

Yayımlanma Tarihi 31 Aralık 2018
Gönderilme Tarihi 14 Mayıs 2018
Kabul Tarihi 25 Aralık 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 9 Sayı: 35

Kaynak Göster

Vancouver Türk O, Yaldız C, Ceylan D. Kronik Subdural Hematomlar: Epidemiyoloji, Radyoloji, Hematolojik Parametreler ve Olgularımızın Cerrahi Sonuçları. mkutfd. 2018;9(35):121-7.