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APRESENTAÇAO CLINICA E PROGNOSTICO DOS PACIENTES COM HEMATOMA SUBDURAL CRONICO

APRESENTAÇAO CLINICA E PROGNOSTICO DOS PACIENTES COM HEMATOMA SUBDURAL CRONICO

(especial para SIIC © Derechos reservados)
pereira9.jpg Autor:
Carlos Umberto Pereira
Columnista Experto de SIIC

Institución:
Universidade Federal de Sergipe


Artículos publicados por Carlos Umberto Pereira
Coautores
Marcelo Barreto Barbosa* Antônio Carlos Silveira Azevedo* Egmond Alves Silva Santos** Carlos Michell Tôrres Santos*** 
Neurocirurgião, Hospital João Alves Filho, Aracaju, Brasil*
Mestre em Medicina, Hospital do Mandaqui, São Paulo, Brasil**
Mestre em Ciências da Saúde, Associação de Ensino e Cultura "Pio Décimo", Aracaju, Brasil***
Recepción del artículo
23 de Julio, 2009
Aprobación
22 de Septiembre, 2009
Primera edición
15 de Febrero, 2010
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Introdução: O hematoma subdural crônico é considerado uma das lesões neurocirúrgicas que apresenta bom prognóstico. Os autores apresentam sua experiência sobre apresentação clínica e prognóstico. Pacientes e métodos: Foram analisados, retrospectivamente, 60 casos de hematoma subdural crônico entre janeiro de 2002 e junho de 2008. Os dados analisados foram características demográficas, quadro clínico, tratamento, complicações e prognóstico. Resultados: A idade variou entre 38 e 82 anos, com média de 58 anos. Houve predomínio do sexo masculino com relação masculino:feminino de 2,53:1. A localização foi unilateral em 49 casos e bilateral em 11 casos. Fatores predisponentes: traumatismo craniano (30), alcoolismo crônico (14), uso de anticoagulante oral (6), outras causas (6) e desconhecido (4). Apresentações clínicas foram: acidente vascular cerebral (16), hipertensão intracraniana (12), distúrbios psiquiátricos (11), síndrome piramidal (8), crises convulsivas (8), sintoma extrapiramidal (4) e hemorragia subaracnóidea (2). Tratamento cirúrgico foi realizado em 58 casos. Os casos de alcoolismo crônico associados à apresentação psiquiátrica tiveram péssimo prognóstico, seguidos dos casos de uso de anticoagulantes orais associados a hipertensão intracraniana. Os resultados foram ótimos em casos de hematoma subdural crônico associados a hipertensão intracraniana e nos casos com clínica piramidal e extrapiramidal. Cinco pacientes foram a óbito (dois por intercorrências cirúrgicas, dois por doenças sistêmicas e um por infecção hospitalar). Conclusão: O hematoma subdural crônico manifesta-se por formas clínicas variadas, seu prognóstico encontra-se diretamente relacionado à causa básica, apresentação clínica e tratamento.

Palabras clave
hematoma subdural crônico, prognóstico, tratamento


Artículo completo

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Abstract
Introduction: Chronic subdural hematoma is considered one of the neurosurgical lesions that has a satisfactory prognosis. The authors describe their experience on clinical presentation and prognosis. Patients and methods: Sixty cases of chronic subdural hematoma were retrospectively analyzed between January 2002 and June 2008. Demographic data, clinical presentation, treatment, complications and prognosis were examined. Results: The age ranged from 38 to 82 years and the average age was 58 years. There was a predominance of males with a relation male/female of 2,53:1. Location was unilateral in 49 cases and bilateral in 11 cases. The predisposing factors were: head trauma (30), alcoholism (14), use of oral anticoagulants (6), other causes (6) and unknown (4). Clinical presentations were stroke (16), intracranial hypertension (12), psychiatric disorders (11), pyramidal syndrome (8), seizures (8), extrapyramidal symptoms (4) and subarachnoid hemorrhage (2). Surgical treatment was performed in 58 cases. Chronic alcoholism cases associated with psychiatric presentation had very bad prognosis and were followed by cases of oral anticoagulants use associated with intracranial hypertension. The results were excellent in cases of chronic subdural hematoma associated with intracranial hypertension and cases with pyramidal and extrapyramidal clinics. Five patients died (two by surgical complications, two by systemic diseases and one due to a hospital infection). Conclusion: Chronic subdural hematoma manifests through several clinical forms and its prognosis is directly related to the cause, clinical presentation and treatment.

Key words
chronic subdural hematoma, prognosis, treatment


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Neurocirugía
Relacionadas: Cuidados Intensivos, Diagnóstico por Imágenes, Educación Médica, Epidemiología, Geriatría, Medicina Interna, Neurología



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Carlos Umberto Pereira, 49015-380, Av. Augusto Maynard 245 / 404 - Bairro São José, Aracaju, Brasil
Bibliografía del artículo

1. Bender MB, Christoff N. Nonsurgical treatment of subdural hematomas. Arch Neurol 31:73-9, 1974.
2. Pereira CU, Dantas MC, Santos EAS, Santos CMT, Monteiro JTS. Hematoma subdural crônico no idoso. Rev Bras Med 63:331-7, 2006.
3. Sambasivan M. An overview of chronic subdural haematoma: experience with 2300 cases. Surg Neurol 47:418-22, 1977.
4. Fogelholm R, Waltino O. Epidemiology of chronic subdural hematoma. Acta Neurochir (Wien) 32:247-50, 1975.
5. Rozzelle CJ, Wofford JL, Branch CL. Predictors of hospital mortality in older patients with subdural hematoma. J Am Geriatr Soc 43:240-4, 1995.
6. Van Havenbergh T, Van Calenbergh F, Goffin J, Plets C. Outcome of chronic subdural haematoma: analysis of prognostic factors. Br J Neurosurg 10:35-9, 1996.
7. Destandau J, Dartigues JF, Cohadon F. Hématome sous-dural chronique de l'adulte. Facteurs pronostiques de la chirurgie. À propos de 100 cas. Neurochirurgie 33:17-22, 1987.
8. Nakaguchi H, Tanishima T, Yoshimasu N. Factors in the natural history of chronic subdural haematoma that influence their postoperative recurrence. J Neurosurg 95:256-62, 2001.
9. Villagrasa J, Prat R, Diaz JF, Comunas F. Analysis of prognostic factors in adults with chronic subdural hematoma. Neurologia 13:120-4, 1998.
10. Fujioka S, Matsukado Y, Kaku M. Analysis of 100 cases with chronic subdural with respect to clinical manifestation and the enlarging process of the hematoma. Neurol Med Chir 21:1153-60, 1981.
11. Houdart R, Rey A. Formes atypiques et trompeuses de l' hématome sousdural chronique. Rev Prat 15:3949-57, 1965.
12. Yamazaki Y, Tachibana S, Kitara Y, Ohwada T. Promotive factors of chronic subdural hematoma in relation to age. No Shinkei Geka 24:47-51, 1996.
13. Fogelholm R, Heiskanen O, Waltimo O. Chronic subdural hematoma in adults. Influence of patient's age on symptoms, signs, and thickness of hematoma. J Neurosurg 42:43-6, 1975.
14. Arseni C, Stanciu M. Particular clinical aspects of chronic subdural haematoma in adults. Europ Neurol 2:109-22, 1969.
15. Black DW. Subdural haematoma . A retrospective study of the "great neurologic imitator". Postgr Med 78:107-14, 1985.
16. Marwalder TM. Chronic subdural haematomas: a review. J Neurosurg 54:637-45, 1981.
17. Pencalet PH. Formes cliniques et facteurs pronostiques de l'hématome sousdural chronique de l'adulte. Neurochirurgie 47:469-72, 2001.
18. Pereira CU. Hematoma subdural crônico no idoso. In: Neurogeriatria. Pereira CU, Andrade AS (eds). Revinter, Rio de Janeiro, pp. 346-9, 2000.
19. Potter JF, Fruin AH. Chronic subdural haematoma - the great imitator. Geriatrics 32:61-6, 1977.
20. Cameron MM. Chronic subdural haematoma: a review of 114 cases. J Neurol Neurosurg Psychiatr 41:834-9, 1978.
21. Jones S, Kafetz K. A prospective study of chronic subdural haematomas in elderly patients. Age Ageing 28:519-21, 1999.
22. Marcu H, Becker H. Computed tomography of bilateral isodense chronic subdural haematoma. Neuroradiology 14:81-3, 1977.
23. Raskind R, Glover MB, Weiss SR. Chronic subdural haematoma in the elderly: a challenge in diagnosis and treatment. J Am Geriatr Soc 20:330- 4, 1972.
24. Zingale A, Albanese V, Romano A, Distefano G, Chiaramonte J. Traumatic chronic subdural haematoma over 80 years . J Neurosurg Sci 41:169-74, 1997.
25. Adhiyaman V, Asghar M, Ganeshram KN, Bhowmick BK. Chronic subdural haematoma in the elderly. Postgrad Med J 78:71-5, 2002.
26. Goto I, Kuroiwa Y, Kitamura K. The triad of neurological manifestations in bilateral chronic subdural hematoma and normal pressure hydrocephalus. J Neurosurg Sci 30:123-8, 1986.
27. Sato T, Takeichi M. A case of chronic subdural hematoma with anxiety states and concomitant regression-like symptoms. Jpn J Psychiatr Neurol 41:663-7, 1987.
28. Cambria S, Daum S, Le Beau J. Les hématomes sousduraux intracrâniens à symptomatologie pyramidale homolatérale. Neurochirurgie 12 :473-90, 1966.
29. Nicoli F, Milandre L, Lemarquis P, Bazan M, Jau P. Hématomes sous-duaux chroniques et déficits neurologiques transitoires. Rev Neurol (Paris) 146:256-63, 1990.
30. Merlicco G, Pierangeli E, Di Padova PL. Chronic subdural hematomas in adults: prognostic factors. Analysis of 70 cases. Neurosurg Rev 18:247-51, 1995.
31. Melamed E, Lavy S, Reches A, Sahar A. Chronic subdural hematoma simulating transient cerebral ischemic attacks. Case report. J Neurosurg 42:101-3, 1975.
32. Moster ML, Johnston DE, Reinmuth OM. Chronic subdural hematoma with transient neurological deficits: a review of 15 cases. Ann Neurol 14:539-42, 1983.
33. Dressler D, Schonle PW. Bilateral limb dystonia due to chronic subdural hematoma. Eur Neurol 30:211-3, 1990.
34. Sunada I, Inoque T, Tamura K, Akano Y, Fu Y. Parkinson due to chronic subdural hematoma. Neurol Med Chir (Tokyo) 36:99-101, 1996.
35. Accardi R, Arnetoli G, Ammannati F. Parkinsonism caused by chronic subdural hematoma. A case report. Ital J Neurol Sci 6:109-111, 1985.
36. Krupp WF, Ians PJ. Treatment of chronic subdural haematoma with burr-hole craniostomy and closed drainage. Br J Neurosurg 9:619-27, 1995.
37. Broderson P, Gjerris F. Regional cerebral blood flow in patients with chronic haematoma. Acta Neurol Scand 51:233-9, 1975.
38. Russell NA, Goumnerova L, Atack EA, Atack DM, Benoit BG. Chronic subdural hematoma mimicking transient ischemic attacks. J Trauma 25:1113-4, 1985.
39. Kotwica Z, Brzezinski J. Chronic subdural hematoma presenting as spontaneous subarachnoid hemorrhage. Report of six cases. J Neurosurg 63:691-2, 1985.
40. Kotwica Z, Brzezinski J. Epilepsy in chronic subdural haematoma. Acta Neurochir (Wien) 113:118-20, 1991.

 
 
 
 
 
 
 
 
 
 
 
 
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