ABSTRACT
El Hematoma Subdural crónico es una patología relativamente frecuente que predomina en adultos mayores. Es de inicio insidioso, su diagnóstico se basa en el cuadro clínico y estudios radiológicos como la tomografía computarizada (TAC), el manejo es predominante quirúrgico y su pronóstico es bueno. Se analiza en el presente estudio, una muestra de 95 expedientes clínicos de pacientes con dicho diagnóstico, síntomas iniciales, TAC pre y post diagnóstico, tratamiento y evolución...
Subject(s)
Humans , Male , Middle Aged , Hematoma, Subdural, Chronic/diagnosis , Hematoma, Subdural, Chronic/etiology , Hematoma, Subdural, Chronic/mortality , Hematoma, Subdural, Chronic , Hematoma, Subdural, Chronic/therapy , Tomography, X-Ray Computed , Costa RicaABSTRACT
O objetivo deste estudo é analisar a evolução de pacientes com hematoma subdural crônico em relação aos achados do coagulograma. Foram analisados 161 pacientes operados no Hospital das Clínicas-UNICAMP entre abril de 1994 e 2000. Foi detectado um predomínio do sexo masculino (86,3 por cento), da cor branca (85,1 por cento) e da faixa etária na quinta década (mediana 57 anos). O estudo mostrou mortalidade maior no período pós-operatório entre os pacientes com valores de RNI (international normalized ratio) superiores a 1,25 e/ou trombocitopenia (p<0,001 e p=0,004, respectivamente) e mortalidade menor para os pacientes com antecedente de traumatismo cranioencefálico (76 por cento) (p=0,044). Os resultados ressaltam a importância da avaliação pré-operatória com o coagulograma a fim de se corrigir possíveis alterações
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Blood Coagulation , Hematoma, Subdural, Chronic/mortality , Hematoma, Subdural, Chronic/surgery , Age Distribution , Age Factors , Blood Coagulation Tests , Brazil/epidemiology , Craniocerebral Trauma/complications , Glasgow Coma Scale , Hematoma, Subdural, Chronic/blood , Postoperative Complications , Retrospective Studies , Sex Distribution , Sex FactorsABSTRACT
BACKGROUND: The lack of specificity and heterogeneity of the clinical picture of chronic subdural hematoma, hampers its diagnosis. AIM: To report the experience of a Neurosurgical Service in chronic subdural hematoma. PATIENTS AND METHODS: One hundred patients (77 male, mean age 77 +/- 13 years) with chronic subdural hematoma were analyzed. RESULTS: The main clinical presentations were mental status changes (50%) and progressive focal neurological deficit (46%). Five cases presented as a transient neurological deficit. All patients were treated with burr hole drainage. Thirteen had recurrence of the hematoma and they were reoperated. The surgical mortality was 3%. Eighty seven patients were followed for a mean of 66 months. Eighty one of these had a complete recovery, 6 had permanent neurological deficit and 2 of these were unable to care for themselves. Bad prognosis was associated with the absence of a previous trauma to explain the hematoma and symptoms of dementia as the clinical presentation. CONCLUSIONS: Most patients with chronic subdural hematoma treated with burr hole drainage have a good outcome.
Subject(s)
Drainage , Hematoma, Subdural, Chronic/surgery , Age Factors , Aged , Analysis of Variance , Chile/epidemiology , Female , Follow-Up Studies , Hematoma, Subdural, Chronic/etiology , Hematoma, Subdural, Chronic/mortality , Humans , Male , Postoperative Complications/mortality , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
The chronic subdural hematoma represents one of the most frequent types of intracranial hemorrhage. One hundred sixty one patients operated in the Clinical Hospital of State University of Campinas-SP (UNICAMP) from April 1994 to May 2000, were analyzed retrospectively in order to characterize the population and to study the importance of the pre-operative coagulation analysis in the outcome. The majority of the population was male (86%), white (85.1%) and in the fifth decade (median age: 57 years). A high mortality index in the postoperative period was found in patients with INR (international normalized ratio) values greater than 1.25 and/or thrombocytopenia (p<0.001 and p=0.004 respectively). Patients with previous head injury history (76%) showed a lower mortality (p=0.044). The results stand out the importance of the pre-operative evaluation with coagulation studies in order to correct possible abnormalities.