• Clin Neurol Neurosurg · Mar 2014

    Predictors of rapid spontaneous resolution of acute subdural hematoma.

    • Kenji Fujimoto, Tadahiro Otsuka, Kimio Yoshizato, and Jun-ichi Kuratsu.
    • Department of Neurosurgery, National Hospital Organization Kumamoto Medical Center, 1-5, Ninomaru, Chuo-ku, Kumamoto 860-0008, Japan; Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto, Kumamoto 861-8556, Japan. Electronic address: schwarz_k1216@yahoo.co.jp.
    • Clin Neurol Neurosurg. 2014 Mar 1; 118: 94-7.

    ObjectiveAcute subdural hematoma (ASDH) usually requires emergency surgical decompression, but rare cases exhibit rapid spontaneous resolution. The aim of this retrospective study was to identify factors predictive of spontaneous ASDH resolution.MethodsA total of 366 consecutive patients with ASDH treated between January 2006 and September 2012 were identified in our hospital database. Patients with ASDH clot thickness >10mm in the frontoparietotemporal region and showing a midline shift >10mm on the initial computed tomography (CT) scan were divided into two groups according to subsequent spontaneous resolution. Univariate and multivariate logistic regression analyses were used to identify factors predictive of rapid spontaneous ASDH resolution.ResultsFifty-six ASDH patients met study criteria and 18 demonstrated rapid spontaneous resolution (32%). Majority of these patients were not operated because of poor prognosis/condition and in accordance to family wishes. Univariate analysis revealed significant differences in use of antiplatelet agents before head injury and in the incidence of a low-density band between the hematoma and inner wall of the skull bone on the initial CT. Use of antiplatelet agents before head injury (OR 19.6, 95% CI 1.5-260.1, p=0.02) and the low-density band on CT images (OR 40.3, 95% CI 3.1-520.2, p=0.005) were identified as independent predictive factors by multivariate analysis.ConclusionsOur analysis suggested that use of antiplatelet agents before head injury and a low-density band between the hematoma and inner skull bone on CT images (indicative of cerebrospinal fluid infusion into the subdural space) increase the probability of rapid spontaneous resolution.Copyright © 2013 Elsevier B.V. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…