Background: A large craniotomy is usually the first choice for removal of traumatic acute subdural hematoma (TASDH). To date, few studies have reported that TASDH could be successfully treated by twist drill craniostomy (TDC) alone or combined with instillation of urokinase. We aimed to define the TDC for the elderly with TASDH and performed literature review.
Case Presentation: A total of 7 TASDH patients, who were presented and treated by TDC in this retrospective study between January 2009 and May 2017, consisted of 5 men and 2 women, ranging in age from 65 to 89 (average, 78.9) years. The patients' baseline characteristics, including age, sex, medical history, received ventriculoperitoneal shunt for hydrocephalus or not, reason for avoiding or refusing large craniotomy, preoperative Glasgow Coma Scale (GCS), suffered from cerebral herniation or not, the location of TASDH, imaging characteristics of TASDH in CT scan, injury/surgery time interval, midline shift, preoperative neurologic deficit, operation time, and infusions of urokinase or not, were collected. The postoperative GCS, postoperative neurologic deficit, rebleeding or not, intracranial infection, and modified Rankin Scale (mRS) at 6 months after surgery were analyzed to access the safety and efficacy of evacuation with TDC. The results showed that the mean time interval from injury to TDC was 68.6 min (30-120 min). The mean distance of midline shift was 14.6 mm (10-20 mm). The preoperative GCS in all patients ranged from 4 to 13(median, 9). The mean duration of the operation was 14.4 min (6-19 min). Postoperative CT scan showed that hematoma evacuation rate was more than 70% in all cases. There were no cases of acute rebleeding and intracranial infection after TDC. No cases presented with chronic SDH at the ipsilateral side within 6 months after being treated by TDC alone or combined with instillation of urokinase. Favorable outcomes were shown in all cases (mRS scores 0-2) at 6 months after surgery.
Conclusions: TASDH in the elderly could be safely and effectively treated by TDC alone or combined with instillation of urokinase, which was a possible alternative for the elderly.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398353 | PMC |
| http://dx.doi.org/10.1186/s41016-019-0157-8 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Bacteriophages targeting Enterococcus faecalis enhance the therapeutic efficacy of levodopa in an MPTP-induced Parkinson's disease mouse model with E. faecalis gut colonization.
Sci Rep
October 2024
Department of Biomedical Sciences, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.
Despite the intensive research on gut microbiome-associated diseases over the past 20 years, pharmacological methods for effectively eliminating pathobionts remain unsatisfactory. This study investigated the therapeutic potential of bacteriophages against Enterococcus faecalis, in which bacterial tyrosine decarboxylase (TDC) converts orally administered levodopa (L-DOPA) to dopamine, in an MPTP mouse model of Parkinson's disease (PD). E.
View Article and Find Full Text PDFEnhanced ADHD classification through deep learning and dynamic resting state fMRI analysis.
Sci Rep
October 2024
Laboratory of Functional Neuroscience and Pathologies (LNFP, UR UPJV 4559), University of Picardy Jules Verne, Amiens, France.
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by deficits in attention, hyperactivity, and/or impulsivity. Resting-state functional connectivity analysis has emerged as a promising approach for ADHD classification using resting-state functional magnetic resonance imaging (rs-fMRI), although with limited accuracy. Recent studies have highlighted dynamic changes in functional connectivity patterns among ADHD children.
View Article and Find Full Text PDFPeriodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 in combination with carbonate apatite granules or rhFGF-2 alone: 12-month randomized controlled trial.
Clin Oral Investig
October 2024
Department of Periodontology, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo, 1010061, Japan.
Objectives: This randomized controlled trial compared the outcomes of recombinant human fibroblast growth factor (rhFGF)-2 plus carbonate apatite (COAp) granules with rhFGF-2 alone in the treatment of intrabony periodontal defects.
Materials And Methods: Patients with Stage III Grade B/C periodontitis who had completed initial periodontal therapy and had intrabony defects with a depth of ≥ 3 mm were included. Defects were treated solely with rhFGF-2 (control) or rhFGF-2 plus COAp (test).
Survival Analysis of Conversion Surgery in Borderline Resectable and Locally Advanced Unresectable Pancreatic Ductal Adenocarcinoma Addressing Selection and Immortal Time Bias: A Retrospective Single-Center Study.
Ann Surg Oncol
December 2024
Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Article Synopsis
- The study evaluated the benefits of surgery after neoadjuvant chemotherapy (NAC) for patients with borderline resectable (BR) or unresectable (UR) pancreatic ductal adenocarcinoma (PDAC), aiming to reduce biases in previous research.
- Researchers analyzed 124 patients from a hospital in Japan and used various statistical methods to control for biases like immortal time bias when comparing outcomes between those who had surgery and those who did not.
- Results showed that surgery after NAC led to significantly better overall survival rates compared to just chemotherapy, highlighting the potential advantages of surgical intervention for these patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!