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Kronik Subdural Hematom Hastalarında Klinik Özellikler: Travma ve Antikoagülan/Antiagregan İlaç Kullanımı, Clinical Features in Chronic Subdural Hematoma Patients: Trauma and Anticoagulant / Antiagregan Drug Used

Year 2018, Volume: 51 Issue: 3, 196 - 200, 26.12.2018

Abstract

Amaç:
Yaşlı popülasyonda sık görülen ve artan insidansa sahip olan kronik subdural
hematom (KSDH) gelişiminin, antikoagülan ve / veya antiagregan tedavi ile travma
ve rekürrens arasındaki ilişki araştırıldı.

Gereç ve Yöntemler:
Kliniğimizde, 2015 Ocak- Ocak 2018 tarihleri arasında KSDH tanısı ile cerrahi
olarak tedavi edilen olguların dosyaları retrospektif olarak incelendi. Yaş,
cinsiyet, kafa travması, antikoagülan ve / veya antiagregan ajan tedavisi ve
eşlik eden hastalık, pıhtılaşma durumu, lateralizan nörolojik bulguları,
cerrahi yöntem ve rekürrens araştırıldı.

Bulgular:
Çalışmaya 104 olgu (79 erkek, 25 kadın) katıldı. Hastaların yaş ortalaması 67,7
± 15,6 (20-94 yaş) idi. 67’si (%64,4) 65 yaş üstündeydi. 29 (%27,9) hastada fokal
nörolojik defisit mevcuttu. Travma öyküsü 71 olguda (%68,3) mevcuttu,
hastaların 57’sinde (%54,8) kronik bir hastalık vardı. 81 olgu (%77,9) tek veya
çift burr-hole kraniyostomi ile tedavi etti.

Sonuç:
Bu çalışmada KSDH’da travma
sıklığının oldukça yüksek olduğu görülmüştür. Travma olan ve olmayan gruplarda
antikoagülan/antiagregan ilaç kullanımı ve komorbid hastalık varlığı
açısından fark gözlenmedi. Nüks
oranın literatür ile benzer olduğu ve cerrahi sonuçlarının başarılı olduğu
görülmüştür.

 











Anahtar kelimeler:
Burr-hole kraniyostomi, kronik subdural hematom, cerrahi, travma

 

ABSTRACT

OBECTIVE:
Chronic subdural
hematoma (CSDH) development is very common among elder population with an
increased incidence under anticoagulant and/or antiaggregant therapy. The
relationship of CSDH and recurrent CSDH development with or without head trauma
under anticoagulant/antiaggregant medication was investigated.



MATERIAL
AND METHODS
: The
patients, diagnosed as CSDH in our clinic between January 2015 and January 2018
were investigated retrospectively. Age, sex, head trauma, anticoagulant and/or
antiaggregant medications, comorbid diseases, coagulation parameters, neurological
findings, surgical method and recurrence of CSDH were documented.



RESULTS:
104 cases (79
males, 25 females) were included in the study. The mean age of the patients was
67.7 ± 15.6 (20-94 years). 67 (64.4%) were over 65 years old. 29 (27.9%)
patients had focal neurological deficits. 71 cases (68.3%) were traumatic and
57 (54.8%) of the patients had a chronic disease. 81 cases (77.9%) were treated
with single or double burr-hole craniostomy.



CONCLUSIONS:
In this study,
trauma frequency was found to be quite high in CSDH. There was no difference between
trauma and non-trauma groups for the presence of anticoagulant and/or
antiaggregant medication and for the presence of comorbid disease. The recurrence
rate was similar to the literature and surgical results were found to be
successful.



Keywords: Burr-hole craniostomy, chronic subdural hematoma,
surgery, trauma

References

  • 1- Baechli H, Nordmann A, Bucher HC, Gratzl O. Demographics and prevalent risk factors of chronic subdural haematoma : results of a large single-center cohort study. Neurosurg Rev 2004;27:263-266.
  • 2- Forster MT, Mathé AK, Senft C, Scharrer I, Seifert V, Gerlach R. The influence of preoperative anticoagulation on outcome and quality of life after surgical treatment of chronic subdural hematoma. J Clin Neurosci 2010;17: 975-979.
  • 3- Gorelick PB, Weisman SM. Risk of hemorrhagic stroke with aspirin use: An update. Stroke 2005;36:1801 7.
  • 4- Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: Clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 2001;41:371 81.
  • 5- Spallone A, Giuffrè R, Gagliardi FM, Vagnozzi R. Chronic subdural hematoma in extremely aged patients. Eur Neurol 1989;29:18 22.
  • 6- Zingale A, Albanese V, Romano A, Distefano G, Chiaramonte J. Traumatic chronic subdural hematoma over 80 years. A preliminary prospective study. J Neurosurg Sci 1997;41:169 73.
  • 7- Aoki N. Chronic subdural hematoma in infancy. Clinical analysis of 30 cases in the CT era. J Neurosurg 1990;73:201 5.
  • 8- Gonugunta V, Buxton N. Warfarin and chronic subdural haematomas. Br J Neurosurg 2001;15:514 7.
  • 9- Markwalder TM, Seiler RW. Chronic subdural hematomas: To drain or not to drain? Neurosurgery 1985;16:185 8.
  • 10- Markwalder TM. Chronic subdural hematomas: A review. J Neurosurg 1981;54:637 45.
  • 11- Probst C. Peritoneal drainage of chronic subdural hematomas in older patients. J Neurosurg 1988;68:908 11.
  • 12- Reinges MH, Hasselberg I, Rohde V, Küker W, Gilsbach JM. Prospective analysis of bedside percutaneous subdural tapping for the treatment of chronic subdural haematoma in adults. J Neurol Neurosurg Psychiatry 2000;69:40 7.
  • 13- Rodziewicz GS, Chuang WC. Endoscopic removal of organized chronic subdural hematoma. Surg Neurol 1995;43:569 72.
  • 14- Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, DeRosa PL, Anderson K, et al. The surgical management of chronic subdural hematoma. Neurosurgical Review 2012;35:155–169.
  • 15- Lega BC, Danish SF, Malhotra NR, Sonnad SS, Stein SC. Choosing the best operation for chronic subdural hematoma: a decision analysis. Journal of Neurosurgery 2010;113:615–21.
  • 16- Santarius T, Kirkpatrick PJ, Ganesan D, Chia HL, Jalloh I, Smielewski P. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomized controlled trial. Lancet 2009;374:1067–73.
  • 17- Jourdan E, Dombret H, Glaisner S, Micléa JM, Castaigne S, Degos L. Unexpected high incidence of intracranial subdural haematoma during intensive chemotherapy for acute myeloid leukaemia with a monoblastic component. British Journal of Haematology 1995;89:527–30.
  • 18- Alimehmeti R, Locatelli M. Epidural B cell non Hodgkin’s lymphoma associated with chronic subdural hematoma. Surgical Neurology 2002;57(3):179–82
  • 19- Çelikoğlu E, İş M, Yılmaz M, Kiraz İ, Ramazanoğlu F, Alkan B. Kronik subdural hematom olgularımızın cerrahi sonuçalrı. Sinir Sistemi Cerrahisi Derg 2014;4:36-41.
  • 20- 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.
  • 21- Weigel R, Hohenstein A, Schlickum L, Weiss C, Schilling L. Angiotensin converting enzyme inhibition for arterial hypertension reduces the risk of recurrence in patients with chronic subdural hematoma possibly by an antiangiogenic mechanism. Neurosurgery 2007;61:788-792.
  • 22- Liu Y, Xia JZ, Wu AH, Wang YJ. Burr-hole craniotomy treating chronic subdural hematoma: a report of 398 cases. Chin J Traumatol 2010;13:265-9.
  • 23- Sim YW, Min KS, Lee MS, , Kim YG, Kim DH Recent Changes in Risk Factors of Chronic Subdural Hematoma. J Korean Neurosurg Soc. 2012 Sep; 52(3): 234–239.
  • 24- Ramachandran R, Hegde T. Chronic subdural hematomas; causes of morbidity and mortality. Surg Neurol 2007;67:367-373.
  • 25- Lindvall P, Koskinen LO. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J Clin Neurosci 2009;16:1287-1290.
  • 26- Rust T, Kiemer N, Erasmus A. Chronic subdural haematomas and anticoagulation or anti-thrombotic therapy. J Clin Neurosci 2006;13:823-827.
  • 27- Wintzen AR, Tijssen JG. Subdural hematoma and oral anticoagulant therapy. Arch Neurol 1982;39:69-72.
  • 28- 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.
  • 29- Lee JY, Ebel H, Ernestus RI, Klug N. Various surgical treatments of chronic subdural hematoma and outcome in 172 patients: is membranectomy necessary? Surg Neurol 2004;61:523-528.
Year 2018, Volume: 51 Issue: 3, 196 - 200, 26.12.2018

Abstract

References

  • 1- Baechli H, Nordmann A, Bucher HC, Gratzl O. Demographics and prevalent risk factors of chronic subdural haematoma : results of a large single-center cohort study. Neurosurg Rev 2004;27:263-266.
  • 2- Forster MT, Mathé AK, Senft C, Scharrer I, Seifert V, Gerlach R. The influence of preoperative anticoagulation on outcome and quality of life after surgical treatment of chronic subdural hematoma. J Clin Neurosci 2010;17: 975-979.
  • 3- Gorelick PB, Weisman SM. Risk of hemorrhagic stroke with aspirin use: An update. Stroke 2005;36:1801 7.
  • 4- Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: Clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 2001;41:371 81.
  • 5- Spallone A, Giuffrè R, Gagliardi FM, Vagnozzi R. Chronic subdural hematoma in extremely aged patients. Eur Neurol 1989;29:18 22.
  • 6- Zingale A, Albanese V, Romano A, Distefano G, Chiaramonte J. Traumatic chronic subdural hematoma over 80 years. A preliminary prospective study. J Neurosurg Sci 1997;41:169 73.
  • 7- Aoki N. Chronic subdural hematoma in infancy. Clinical analysis of 30 cases in the CT era. J Neurosurg 1990;73:201 5.
  • 8- Gonugunta V, Buxton N. Warfarin and chronic subdural haematomas. Br J Neurosurg 2001;15:514 7.
  • 9- Markwalder TM, Seiler RW. Chronic subdural hematomas: To drain or not to drain? Neurosurgery 1985;16:185 8.
  • 10- Markwalder TM. Chronic subdural hematomas: A review. J Neurosurg 1981;54:637 45.
  • 11- Probst C. Peritoneal drainage of chronic subdural hematomas in older patients. J Neurosurg 1988;68:908 11.
  • 12- Reinges MH, Hasselberg I, Rohde V, Küker W, Gilsbach JM. Prospective analysis of bedside percutaneous subdural tapping for the treatment of chronic subdural haematoma in adults. J Neurol Neurosurg Psychiatry 2000;69:40 7.
  • 13- Rodziewicz GS, Chuang WC. Endoscopic removal of organized chronic subdural hematoma. Surg Neurol 1995;43:569 72.
  • 14- Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, DeRosa PL, Anderson K, et al. The surgical management of chronic subdural hematoma. Neurosurgical Review 2012;35:155–169.
  • 15- Lega BC, Danish SF, Malhotra NR, Sonnad SS, Stein SC. Choosing the best operation for chronic subdural hematoma: a decision analysis. Journal of Neurosurgery 2010;113:615–21.
  • 16- Santarius T, Kirkpatrick PJ, Ganesan D, Chia HL, Jalloh I, Smielewski P. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomized controlled trial. Lancet 2009;374:1067–73.
  • 17- Jourdan E, Dombret H, Glaisner S, Micléa JM, Castaigne S, Degos L. Unexpected high incidence of intracranial subdural haematoma during intensive chemotherapy for acute myeloid leukaemia with a monoblastic component. British Journal of Haematology 1995;89:527–30.
  • 18- Alimehmeti R, Locatelli M. Epidural B cell non Hodgkin’s lymphoma associated with chronic subdural hematoma. Surgical Neurology 2002;57(3):179–82
  • 19- Çelikoğlu E, İş M, Yılmaz M, Kiraz İ, Ramazanoğlu F, Alkan B. Kronik subdural hematom olgularımızın cerrahi sonuçalrı. Sinir Sistemi Cerrahisi Derg 2014;4:36-41.
  • 20- 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.
  • 21- Weigel R, Hohenstein A, Schlickum L, Weiss C, Schilling L. Angiotensin converting enzyme inhibition for arterial hypertension reduces the risk of recurrence in patients with chronic subdural hematoma possibly by an antiangiogenic mechanism. Neurosurgery 2007;61:788-792.
  • 22- Liu Y, Xia JZ, Wu AH, Wang YJ. Burr-hole craniotomy treating chronic subdural hematoma: a report of 398 cases. Chin J Traumatol 2010;13:265-9.
  • 23- Sim YW, Min KS, Lee MS, , Kim YG, Kim DH Recent Changes in Risk Factors of Chronic Subdural Hematoma. J Korean Neurosurg Soc. 2012 Sep; 52(3): 234–239.
  • 24- Ramachandran R, Hegde T. Chronic subdural hematomas; causes of morbidity and mortality. Surg Neurol 2007;67:367-373.
  • 25- Lindvall P, Koskinen LO. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J Clin Neurosci 2009;16:1287-1290.
  • 26- Rust T, Kiemer N, Erasmus A. Chronic subdural haematomas and anticoagulation or anti-thrombotic therapy. J Clin Neurosci 2006;13:823-827.
  • 27- Wintzen AR, Tijssen JG. Subdural hematoma and oral anticoagulant therapy. Arch Neurol 1982;39:69-72.
  • 28- 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.
  • 29- Lee JY, Ebel H, Ernestus RI, Klug N. Various surgical treatments of chronic subdural hematoma and outcome in 172 patients: is membranectomy necessary? Surg Neurol 2004;61:523-528.
There are 29 citations in total.

Details

Primary Language Turkish
Journal Section Original research article
Authors

Özhan Uçkun 0000-0002-3845-2665

Denizhan Divanlıoğlu This is me 0000-0003-0267-196X

Ergün Dağlıoğlu 0000-0002-7162-3999

Fatih Alagöz This is me 0000-0001-6910-0585

Ali Dalgıç 0000-0003-1000-2811

Ahmet Deniz Belen This is me 0000-0001-8482-4725

Publication Date December 26, 2018
Submission Date June 13, 2018
Published in Issue Year 2018 Volume: 51 Issue: 3

Cite

AMA Uçkun Ö, Divanlıoğlu D, Dağlıoğlu E, Alagöz F, Dalgıç A, Belen AD. Kronik Subdural Hematom Hastalarında Klinik Özellikler: Travma ve Antikoagülan/Antiagregan İlaç Kullanımı, Clinical Features in Chronic Subdural Hematoma Patients: Trauma and Anticoagulant / Antiagregan Drug Used. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. December 2018;51(3):196-200.