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"name": "Comment diagnostique-t-on un hématome subdural aigu ?",
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"text": "Un scanner cérébral est généralement utilisé pour visualiser l'hématome."
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"name": "Quels tests sont nécessaires après un traumatisme crânien ?",
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"name": "Quelle est l'importance de l'évaluation neurologique ?",
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"name": "Quels sont les symptômes d'un hématome subdural aigu ?",
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"@type": "Question",
"name": "Les symptômes peuvent-ils apparaître rapidement ?",
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"text": "Oui, les symptômes peuvent survenir rapidement après le traumatisme, parfois en quelques heures."
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"name": "Y a-t-il des symptômes spécifiques chez les personnes âgées ?",
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"@type": "Question",
"name": "Les personnes âgées doivent-elles prendre des précautions ?",
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"name": "Les médicaments anticoagulants augmentent-ils le risque ?",
"position": 15,
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"text": "Oui, les anticoagulants peuvent augmenter le risque d'hématomes en cas de traumatisme."
}
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"name": "Quel est le traitement principal pour un hématome subdural aigu ?",
"position": 16,
"acceptedAnswer": {
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"text": "La chirurgie, comme la déviation du sang, est souvent nécessaire pour soulager la pression."
}
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"name": "Quand est-il nécessaire d'intervenir chirurgicalement ?",
"position": 17,
"acceptedAnswer": {
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"text": "Une intervention est nécessaire si l'hématome provoque une pression intracrânienne élevée."
}
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"@type": "Question",
"name": "Peut-on traiter un hématome subdural sans chirurgie ?",
"position": 18,
"acceptedAnswer": {
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"text": "Dans certains cas légers, une surveillance et un traitement médical peuvent suffire."
}
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{
"@type": "Question",
"name": "Quels médicaments peuvent être utilisés ?",
"position": 19,
"acceptedAnswer": {
"@type": "Answer",
"text": "Des analgésiques et des anti-inflammatoires peuvent être prescrits pour soulager la douleur."
}
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{
"@type": "Question",
"name": "Quelles sont les options de réhabilitation après traitement ?",
"position": 20,
"acceptedAnswer": {
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"text": "La réhabilitation peut inclure la physiothérapie et la thérapie occupationnelle."
}
},
{
"@type": "Question",
"name": "Quelles complications peuvent survenir après un hématome subdural ?",
"position": 21,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les complications incluent des lésions cérébrales permanentes et des troubles neurologiques."
}
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"@type": "Question",
"name": "L'hématome peut-il réapparaître après traitement ?",
"position": 22,
"acceptedAnswer": {
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"text": "Oui, un hématome peut réapparaître, surtout si la cause sous-jacente n'est pas traitée."
}
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"@type": "Question",
"name": "Quels sont les risques de décès liés à un hématome subdural ?",
"position": 23,
"acceptedAnswer": {
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}
},
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"@type": "Question",
"name": "Comment les troubles cognitifs peuvent-ils se manifester ?",
"position": 24,
"acceptedAnswer": {
"@type": "Answer",
"text": "Ils peuvent se manifester par des problèmes de mémoire, de concentration et de jugement."
}
},
{
"@type": "Question",
"name": "Les convulsions sont-elles une complication possible ?",
"position": 25,
"acceptedAnswer": {
"@type": "Answer",
"text": "Oui, des convulsions peuvent survenir en raison de l'irritation cérébrale causée par l'hématome."
}
},
{
"@type": "Question",
"name": "Quels sont les principaux facteurs de risque ?",
"position": 26,
"acceptedAnswer": {
"@type": "Answer",
"text": "Les facteurs incluent l'âge avancé, les anticoagulants et les antécédents de traumatismes."
}
},
{
"@type": "Question",
"name": "Les personnes ayant des troubles de la coagulation sont-elles à risque ?",
"position": 27,
"acceptedAnswer": {
"@type": "Answer",
"text": "Oui, elles sont plus susceptibles de développer des hématomes après un traumatisme."
}
},
{
"@type": "Question",
"name": "Le sexe influence-t-il le risque d'hématome subdural ?",
"position": 28,
"acceptedAnswer": {
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"text": "Des études montrent que les hommes sont généralement plus à risque que les femmes."
}
},
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"@type": "Question",
"name": "Les antécédents d'accidents augmentent-ils le risque ?",
"position": 29,
"acceptedAnswer": {
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"@type": "Question",
"name": "Les maladies neurodégénératives sont-elles un facteur de risque ?",
"position": 30,
"acceptedAnswer": {
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"text": "Oui, elles peuvent augmenter la vulnérabilité aux traumatismes crâniens et aux hématomes."
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From the Division of Neurosurgery, Addenbrooke's Hospital (P.J.H., H.A., M.M., E.V., A.E.H., I.S.T., C.T., A.G.K.), the Department of Clinical Neurosciences (P.J.H., H.A., M.M., H.M., M.G.S., E.V., A.E.H., I.S.T., C.T., A.G.K.), and the Division of Anaesthesia (D.K.M.), University of Cambridge, and the Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust (C.T.), Cambridge, the Neurosurgery Department, Royal London Hospital (C.U., S.H.), and the Department of Neurosurgery, Imperial Neurotrauma Centre, Imperial College Academic Health Sciences Centre, St. Mary's Hospital (M.H.W.), London, Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust, Southampton (D.B., A.Z.), the Department of Neurosurgery, Walton Centre NHS Foundation Trust, Liverpool (C.J.M., M.G.S.), the Department of Neurosurgery and the Academic Directorate of Neurosciences, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield (Y.Z.A.-T.), the Department of Neurosurgery, Leeds General Infirmary, Leeds (S.T.), the Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham (A.B.), the Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Manchester (A.T.K.), Norwich Medical School, University of East Anglia, Norwich (S.P., G.B.), and the Neurosurgical Trials Group, Wolfson Research Centre, Newcastle University, Newcastle upon Tyne (B.G.) - all in the United Kingdom; the Department of Neurosurgery, National Institute of Mental Health and Neurosciences (B.I.D., D.P.S.), and the Department of Neurosurgery, Aster RV Hospital (D.I.B.), Bangalore, the Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi (D.K.G.), and the Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh (M.K.T., M.T.) - all in India; the Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium (A.R.M.); Humanitas Research Hospital-IRCCS and Humanitas University, Rozzano, Milan (F.S.); and the University of California, San Francisco, San Francisco (G.T.M.).
From the Division of Neurosurgery, Addenbrooke's Hospital (P.J.H., H.A., M.M., E.V., A.E.H., I.S.T., C.T., A.G.K.), the Department of Clinical Neurosciences (P.J.H., H.A., M.M., H.M., M.G.S., E.V., A.E.H., I.S.T., C.T., A.G.K.), and the Division of Anaesthesia (D.K.M.), University of Cambridge, and the Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust (C.T.), Cambridge, the Neurosurgery Department, Royal London Hospital (C.U., S.H.), and the Department of Neurosurgery, Imperial Neurotrauma Centre, Imperial College Academic Health Sciences Centre, St. Mary's Hospital (M.H.W.), London, Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust, Southampton (D.B., A.Z.), the Department of Neurosurgery, Walton Centre NHS Foundation Trust, Liverpool (C.J.M., M.G.S.), the Department of Neurosurgery and the Academic Directorate of Neurosciences, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield (Y.Z.A.-T.), the Department of Neurosurgery, Leeds General Infirmary, Leeds (S.T.), the Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham (A.B.), the Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Manchester (A.T.K.), Norwich Medical School, University of East Anglia, Norwich (S.P., G.B.), and the Neurosurgical Trials Group, Wolfson Research Centre, Newcastle University, Newcastle upon Tyne (B.G.) - all in the United Kingdom; the Department of Neurosurgery, National Institute of Mental Health and Neurosciences (B.I.D., D.P.S.), and the Department of Neurosurgery, Aster RV Hospital (D.I.B.), Bangalore, the Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi (D.K.G.), and the Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh (M.K.T., M.T.) - all in India; the Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium (A.R.M.); Humanitas Research Hospital-IRCCS and Humanitas University, Rozzano, Milan (F.S.); and the University of California, San Francisco, San Francisco (G.T.M.).
Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland; Division of Clinical Neurosciences, Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland.
The pathogenesis of chronic subdural hematoma (CSDH) has not been completely understood. However, different mechanisms can result in space-occupying subdural fluid collections, one pathway can be the ...
All patients with unilateral CSDH, requiring burr hole trephination between 2018 and 2023 were included. The population was distributed into an acute-to-chronic group (group A, n = 41) and into a conv...
In group A, volume and midline shift increased significantly during the progression from acute-to-chronic (p < 0.001, resp.). Clinical performance (modified Rankin scale, Glasgow Coma Scale) dropped s...
If ASDH transforms to CSDH, treatment may become mandatory early due to increase in volume and midline shift. Close monitoring of these patients is crucial since DOC and rapid deterioration is common ...
Acute subdural hematoma (ASH) is responsible for significant morbidity and mortality in the elderly. As military neurosurgeons, we perform a simplified technique using a linear skin incision and a sma...
The patient lies supine, a pad under the shoulder ipsilateral to the ASH, the head completely rotated on the other side and placed on a circular pad, without head clamp. The linear frontotemporal skin...
The patient is allowed to sit at postoperative day 1 and to walk at postoperative day 2. Simplified craniotomy for ASH allows to reduce operative time and provides faster functional recovery....
Acute subdural hematoma (ASDH) is a life-threatening condition, and hematoma removal is necessary as a lifesaving procedure when the intracranial pressure is highly elevated. However, whether decompre...
From January 1, 2017, to December 31, 2022, 372 patients with traumatic ASDH were admitted to our institution, among whom 48 underwent hematoma evacuation during the acute phase. HC was performed in c...
Of the 48 patients, 2 underwent DC, 23 underwent HC, and 23 underwent CC. The overall mortality rate was 20.8% (10/48) at discharge and 30.0% (12/40) at 6 months. The in-hospital mortality rates for D...
The strategy of performing HC as the first-line operation for ASDH did not increase the mortality rate compared with past surgical reports and required secondary DC in only one case....
Seizures and status epilepticus (SE) are frequent complications of acute subdural hematoma (aSDH) associated with increased morbidity and mortality. Therefore, we aimed to evaluate whether invasive su...
Prospective, single-center, cohort trial....
Neurologic and neurosurgical ICUs of one academic hospital in Germany....
Patients with aSDH undergoing surgical treatment. In total, 76 patients were enrolled in this study, 31 patients (40.8%) were assigned to the invasive electroencephalogram (iEEG) monitoring group and ...
The electrode group was implanted with a subdural strip electrode providing up to 7 days of real-time electroencephalogram recording in the neurointensive care unit, whereas the control group received...
The trial was stopped after a study committee meeting when the prespecified criteria were met. The iEEG and control groups were well-matched for clinical characteristics at admission. Frequencies of s...
Invasive subdural electroencephalogram monitoring is valuable and safe for early seizure/SE detection and treatment and might improve outcomes in the neurocritical care of patients with aSDH....
Chronic subdural hematoma is a common disease in neurosurgery, but organized chronic subdural hematoma is rarely seen clinically. This article reports a case of misdiagnosis of organized chronic subdu...
The early symptoms of organized chronic subdural hematoma are atypical, with insidious onset and easy misdiagnosis. By carefully inquiring about the medical history and carefully reading the head CT, ...
A female in her 50s developed a headache, collapsed and was noted to have an acute atraumatic subdural haemorrhage (SDH) requiring surgical evacuation and intracranial pressure-directed therapy. Her b...
To estimate the cost-effectiveness of craniotomy, compared with decompressive craniectomy (DC) in UK patients undergoing evacuation of acute subdural haematoma (ASDH)....
Economic evaluation undertaken using health resource use and outcome data from the 12-month multicentre, pragmatic, parallel-group, randomised, Randomised Evaluation of Surgery with Craniectomy for Pa...
UK secondary care....
248 UK patients undergoing surgery for traumatic ASDH were randomised to craniotomy (N=126) or DC (N=122)....
Surgical evacuation via craniotomy (bone flap replaced) or DC (bone flap left out with a view to replace later: cranioplasty surgery)....
In the base-case analysis, costs were estimated from a National Health Service and Personal Social Services perspective. Outcomes were assessed via the quality-adjusted life-years (QALY) derived from ...
In the cost-utility analysis, the mean incremental cost of craniotomy compared with DC was estimated to be -£5520 (95% CI -£18 060 to £7020) with a mean QALY gain of 0.093 (95% CI 0.029 to 0.156). In ...
In a UK population with traumatic ASDH, craniotomy was estimated to be cost-effective compared with DC: craniotomy was estimated to have a lower mean cost, higher mean QALY gain and higher probability...
Ethical approval for the trial was obtained from the North West-Haydock Research Ethics Committee in the UK on 17 July 2014 (14/NW/1076)....
ISRCTN87370545....
Traumatic acute subdural hematoma (ASDH) is a medical emergency that requires prompt neurosurgical intervention. Urgent surgical evacuation may be performed with craniotomy (CO) and decompressive cran...
A systematic search was conducted until August 28, 2023. We identified studies performing ASDH evacuation with CO or DC. Outcomes included Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), GOS-Ex...
Among 684 published articles, we included the Randomized Evaluation of Surgery with Craniectomy for Patients Undergoing Evacuation of ASDH (RESCUE-ASDH) trial, 4 propensity score-matched (PSM) cohorts...
Patients with ASDH undergoing DC across unmatched cohorts had a worse GCS at admission. Although ASDH mortality was lower in the CO group, these findings are derived from unmatched cohorts, potentiall...
Chronic subdural hematoma (cSDH) ranks among the most prevalent neurosurgical conditions, with burr-hole drainage typically yielding favorable prognoses. Nevertheless, perioperative complications may ...
This study presents three cases of postoperative aSDH in elderly patients with cSDH, examining potential causative factors and proposing pertinent strategies. Three elderly patients, admitted urgently...
Urokinase-mediated subdural thrombolysis enhances hematoma clearance rates, suggesting a shift towards minimally invasive treatments to mitigate greater trauma. However, the paucity of evidence necess...
A 72-year-old right-handed female patient was operated on for left-sided acute subdural hematoma responsible for coma. Two weeks afterward, her neurological status had improved with a Glasgow Coma Sca...