Combined Strategy of Burr Hole Surgery and Elective Craniotomy under Intracranial Pressure Monitoring for Severe Acute Subdural Hematoma

التفاصيل البيبلوغرافية
العنوان: Combined Strategy of Burr Hole Surgery and Elective Craniotomy under Intracranial Pressure Monitoring for Severe Acute Subdural Hematoma
المؤلفون: Yuichi Fujiyama, Eiichi Suehiro, Michiyasu Suzuki, Mizuya Shinoyama, Kohei Haji, Miwa Kiyohira
المصدر: Neurologia medico-chirurgica
بيانات النشر: The Japan Neurosurgical Society, 2021.
سنة النشر: 2021
مصطلحات موضوعية: medicine.medical_specialty, Blood transfusion, Intracranial Pressure, medicine.medical_treatment, Transfusion volume, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, posttraumatic coagulopathy, Trephining, Coagulopathy, Medicine, Hematoma, Subdural, Acute, Humans, Craniotomy, Intracranial pressure, medicine.diagnostic_test, burr hole surgery, business.industry, intercranial pressure, severe acute subdural hematoma, medicine.disease, Surgery, Treatment Outcome, Hematoma, Subdural, Chronic, Intracranial pressure monitoring, Drainage, Original Article, Neurology (clinical), business, Acute subdural hematoma, large craniotomy, 030217 neurology & neurosurgery, Partial thromboplastin time
الوصف: Burr hole surgery in the emergency room can be lifesaving for patients with acute subdural hematoma (ASDH). In the first part of this study, a strategy of combined burr hole surgery, a period of intracranial pressure (ICP) monitoring, and then craniotomy was examined for safe and effective treatment of ASDH. Since 2012, 16 patients with severe ASDH with indications for burr hole surgery were admitted to Kenwakai Otemachi Hospital. From 2012 to 2016, craniotomy was performed immediately after burr hole surgery (emergency [EM] group, n = 10). From 2017, an ICP sensor was placed before burr hole surgery. After a period for correction of traumatic coagulopathy, craniotomy was performed when ICP increased (elective [EL] group, n = 6). Patient background, bleeding tendency, intraoperative blood transfusion, and outcomes were compared between the groups. In the second part of the study, ICP was measured before and after burr hole surgery in seven patients (including two of the six in the EL group) to assess the effect of this surgery. Activated partial thromboplastin time (APTT) and prothrombin time-international normalized ratio (PT-INR) were significantly prolonged after craniotomy in the EM group, but not in the EL group, and the EM group tended to require a higher intraoperative transfusion volume. The rate of good outcomes was significantly higher in the EL group, and ICP was significantly decreased after burr hole surgery. These results suggest the value of burr hole surgery followed by ICP monitoring in patients with severe ASDH. Craniotomy can be performed safely using this method, and this may contribute to improved outcomes.
اللغة: English
تدمد: 1349-8029
0470-8105
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::60b36e75b7db3df91dbfe23a72c1e1c4Test
http://europepmc.org/articles/PMC8048118Test
حقوق: OPEN
رقم الانضمام: edsair.doi.dedup.....60b36e75b7db3df91dbfe23a72c1e1c4
قاعدة البيانات: OpenAIRE