دورية أكاديمية
Change in Hematoma Size after Dexamethasone Therapy in Chronic Subdural Hematoma Subtypes:A Prospective Study in Symptomatic Patients
| العنوان: | Change in Hematoma Size after Dexamethasone Therapy in Chronic Subdural Hematoma Subtypes:A Prospective Study in Symptomatic Patients |
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| المؤلفون: | Miah, Ishita P., Blanter, Anastassia, Tank, Yeliz, van Zwet, Erik W., Rosendaal, Frits R., Peul, Wilco C., Dammers, Ruben, Holl, Dana C., Lingsma, Hester F., den Hertog, Heleen M., van der Naalt, Joukje, Jellema, Korné, Van der Gaag, Niels A. |
| المصدر: | Miah , I P , Blanter , A , Tank , Y , van Zwet , E W , Rosendaal , F R , Peul , W C , Dammers , R , Holl , D C , Lingsma , H F , den Hertog , H M , van der Naalt , J , Jellema , K & Van der Gaag , N A 2023 , ' Change in Hematoma Size after Dexamethasone Therapy in Chronic Subdural Hematoma Subtypes : A Prospective Study in Symptomatic Patients ' , Journal of Neurotrauma , vol. 40 , no. 3-4 , .... |
| سنة النشر: | 2023 |
| الوصف: | The main treatment strategy for chronic subdural hematoma is surgical intervention. When a conservative pharmacological approach is considered in symptomatic patients, mainly dexamethasone therapy is applied. Recent trials revealed dexamethasone therapy to be an ineffective treatment in symptomatic patients with chronic subdural hematoma. Whether the efficacy of dexamethasone therapy differs in radiological hematoma subtypes is unknown. The aim of this substudy was to identify which hematoma subtype might be favorable for dexamethasone therapy. As part of a randomized controlled trial, symptomatic chronic subdural hematoma patients received 19-days dexamethasone therapy. The primary outcome measure was the change in hematoma size as measured on follow-up computed tomography (CT) after 2 weeks of dexamethasone in six hematoma (architectural and density) subtypes: homogeneous total, laminar, separated and trabecular architecture types, and hematoma without hyperdense components (homogeneous hypodense, isodense) and with hyperdense components (homogeneous hyperdense, mixed density). We analyzed hematoma thickness, midline shift, and volume using multi-variable linear regression adjusting for age, sex and baseline value of the specific radiological parameter. From September 2016 until February 2021, 85 patients were included with a total of 114 chronic subdural hematoma. The mean age was 76 years and 25% were women. Larger decrease in hematoma thickness and midline shift was revealed in hematoma without hyperdense components compared with hematoma with hyperdense components (adjusted [adj.] b -2.2 mm, 95% confidence interval [CI] -4.1 to -0.3 and adj. b -1.3 mm, 95% CI -2.7 to 0.0 respectively). Additional surgery was performed in 57% of patients with the highest observed rate (81%) in separated hematoma. Largest hematoma reduction and better clinical improvement was observed in chronic subdural hematoma without hyperdense components after dexamethasone therapy. Evaluation of these parameters can be part of an ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://pure.eur.nl/en/publications/c6537618-9e67-4a53-93f4-33980a7a72f7Test |
| DOI: | 10.1089/neu.2022.0024 |
| الإتاحة: | https://doi.org/10.1089/neu.2022.0024Test https://pure.eur.nl/en/publications/c6537618-9e67-4a53-93f4-33980a7a72f7Test http://www.scopus.com/inward/record.url?scp=85147318351&partnerID=8YFLogxKTest https://pure.rug.nl/ws/files/575074964/neu.2022.0024.pdfTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.B020E2B5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1089/neu.2022.0024 |
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