How to Treat Chronic Subdural Hematoma? Past and Now
Journal of Korean Neurosurgical Society
;
: 144-152, 2019.
Artigo
em Inglês
| WPRIM
| ID: wpr-765339
ABSTRACT
Treatment of chronic subdural hematoma (CSDH) is relatively straightforward, however, there is still some debate regarding the best strategy for treatment. The most practical recommendations of up to date were identified by a review of literature. The author reviewed the literature on CSDH management from the past to now to identify the best methods. Till 1970s, craniotomy was the most commonly used method. Burr hole (BH) became the most preferred method from 1980s. In 1977, twist drill (TD) craniostomy was introduced. Closed system drainage after a BH or a TD became the most frequently used surgical method. Although nonsurgical treatment is often successful, trephination has more advantages, such as rapid resolution of the symptoms and short period of hospitalization. Nonsurgical treatment is possible in asymptomatic patients with a small CSDH. For the symptomatic patients with CSDH, trephination is the treatment of choice, either by BH or TD. In gray zone between surgery and medical treatment, shared decision making can be an ideal approach. For the recurrent CSDHs, repeated trephination is still effective for patients with a low risk of recurrence. If the risk of recurrence is high, additional management would be helpful. For the refractory CSDHs, it is necessary to obliterate the subdural space.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Recidiva
/
Espaço Subdural
/
Trepanação
/
Drenagem
/
Craniotomia
/
Hematoma Subdural Crônico
/
Tomada de Decisões
/
Traumatismos Craniocerebrais
/
Hospitalização
/
Métodos
Tipo de estudo:
Guia de Prática Clínica
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2019
Tipo de documento:
Artigo
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