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hematoma_subdural_cronico [2019/06/18 21:02]
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hematoma_subdural_cronico [2019/06/18 21:03] (actual)
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 [[Tratamiento del hematoma subdural crónico]]. [[Tratamiento del hematoma subdural crónico]].
 +
 +====Complicaciones====
 +ver [[Hematoma subdural crónico complicaciones]]
 +
 +
 +====Pronóstico====
 +
 +Los principales factores asociados a los resultados son la puntuación Glasgow en el momento de admisión y la recidiva. La edad avanzada no es una contraindicación para el tratamiento quirúrgico (De Araújo Silva y col., 2012).
 +
 +Aunque persista colección hemática tras la intervención se suele reabsorber en los próximos meses.
 +No se recomienda intervenir con la excepción de que la colección sea mayor que antes de la operación o que no se resuelvan los síntomas previos.
 +
 +En una serie se encontró un drenaje incompleto en el 18% de los casos y neumoencéfalo en el 11% de los casos. La mortalidad fue del 2%, que era inferior al publicado en estudios anteriores (Sikahall-Meneses,​ Salazar-Perez et al. 2008).
 +
 +Dumont y col., proponen que el hematoma subdural crónico, debe ser concebido como un [[evento centinela|evento centinela]] en los ancianos y así analizar la supervivencia a largo plazo ya que las tasas de mortalidad aumenta en este tipo de pacientes, en relación con los datos de mortalidad estandarizadas (Dumont y col., 2012).
 +
 +====Hoja operatoria====
 +Bajo [[anestesia general]], [[intubación orotraqueal]] y [[profilaxis antibiótica]] con [[cefazolina]] 2 gr IV.
 +
 +Colocación del paciente en [[decúbito supino]] lateralizado hacia la derecha sobre Donut.
 +
 +Antisepsia cutánea y planificación del abordaje
 +
 +[[Incisión cutánea]] sobre la región frontotemporal
 +
 +Exposición del área para el [[trépano]] y apertura dural en cruz. 
 +
 +Salida a presión de hematoma con aspecto de aceite de motor.
 +
 +Lavado con abundante suero hasta apreciar salida de líquido claro.
 +
 +Reexpansión incompleta. Colocación de drenaje.
 +
 +[[Hemostasia]] y cierre de plano muscular-subcutaneo con reabsorbible
 +
 +Cierre de piel con grapas. ​
 +
 +===== Informe de alta =====
 +
 +[[Informe de alta de hematoma subdural crónico]]
 +
 +====Bibliografía====
 +
 +Baechli, H, A Nordmann, H C Bucher, and O Gratzl. 2004. “Demographics and Prevalent Risk Factors of Chronic Subdural Haematoma: Results of a Large Single-center Cohort Study.” Neurosurgical Review 27 (4) (October): 263–266. doi:​10.1007/​s10143-004-0337-6.
 +
 +Berghauser Pont LM, Dammers R, Schouten JW, Lingsma HF, Dirven CM. Clinical factors
 +associated with outcome in chronic subdural hematoma: a retrospective cohort study of
 +patients on pre-operative corticosteroid therapy [published on line ahead of print September
 +20, 2011]. Neurosurgery. doi: 10.1227/​NEU.0b013e31823672ad
 +
 +Berghauser Pont, L M E, D W J Dippel, B H Verweij, C M F Dirven, and R Dammers. 2012. “Ambivalence Among Neurologists and Neurosurgeons on the Treatment of Chronic Subdural Hematoma: a National Survey.” Acta Neurologica Belgica (September 14). doi:​10.1007/​s13760-012-0130-1. http://​www.ncbi.nlm.nih.gov/​pubmed/​22975837.
 +
 +Chon, Kyu-Hyon, Jong-Myong Lee, Eun-Jeong Koh, and Ha-Young Choi. 2012. “Independent Predictors for Recurrence of Chronic Subdural Hematoma.” Acta Neurochirurgica (June 1). doi:​10.1007/​s00701-012-1399-9. http://​www.ncbi.nlm.nih.gov/​pubmed/​22653496.
 +
 +De Araújo Silva, Danilo Otávio, Georgios K Matis, Leonardo Ferraz Costa, Matheus Augusto Pinto Kitamura, Eduardo Vieira de Carvalho Junior, Monalisa de Moura Silva, Breno José A P Barbosa, et al. 2012. “Chronic Subdural Hematomas and the Elderly: Surgical Results from a Series of 125 Cases: Old ‘Horses’ Are Not to Be Shot!” Surgical Neurology International 3: 150. doi:​10.4103/​2152-7806.104744.
 +
 +Ducruet, Andrew F, Bartosz T Grobelny, Brad E Zacharia, Zachary L Hickman, Peter L DeRosa, Kristen Anderson, Eric Sussman, Austin Carpenter, and E Sander Connolly Jr. 2012. “The Surgical Management of Chronic Subdural Hematoma.” Neurosurgical Review 35 (2) (April): 155–169; discussion 169. doi:​10.1007/​s10143-011-0349-y.
 +
 +Dumont, Travis M, Anand I Rughani, Tara Goeckes, and Bruce I Tranmer. 2012. “Chronic Subdural Hematoma: A Sentinel Health Event.” World Neurosurgery (June 18). doi:​10.1016/​j.wneu.2012.06.026. http://​www.ncbi.nlm.nih.gov/​pubmed/​22722034.
 +
 +Forster, M T, A K Mathé, C Senft, I Scharrer, V Seifert, and R Gerlach. 2010. “The Influence of Preoperative Anticoagulation on Outcome and Quality of Life After Surgical Treatment of Chronic Subdural Hematoma.” Journal of Clinical Neuroscience:​ Official Journal of the Neurosurgical Society of Australasia 17 (8) (August): 975–979. doi:​10.1016/​j.jocn.2009.11.023.
 +
 +Gautschi, O P, M N Gallay, T T Kress, W C Korte, and G Hildebrandt. 2010. “[Chronic Subdural Hematoma - Assessment and Management].” Praxis 99 (21) (October 20): 1269–1277. doi:​10.1024/​1661-8157/​a000275.
 +
 +Gelabert-González,​ Miguel, Carla Frieiro-Dantas,​ Ramón Serramito-García,​ Lucía Díaz-Cabanas,​ Eduardo Aran-Echabe,​ María Rico-Cotelo,​ and Alfredo García-Allut. 2012. “[Chronic Subdural Hematoma in Young Patients.].” Neurocirugia (Asturias, Spain) (November 15). doi:​10.1016/​j.neucir.2012.08.002.
 +
 +Jomli, R, Y Zgueb, F Nacef, and S Douki. 2012. “[Chronic Subdural Hematoma and Psychotic Decompensation].” L’Encéphale 38 (4) (September):​ 356–359. doi:​10.1016/​j.encep.2011.11.008.
 +
 +Juković, Mirela, Zeljko Kojadinović,​ Biljana Popovska, and Viktor Till. 2012. “Complete Spontaneous Resolution of Compressive Chronic Subdural Hematoma in a Patient with Liver Failure.” Medicinski Glasnik: Official Publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 9 (2) (August): 412–417.
 +
 +Kaliaperumal,​ Chandrasekaran,​ Ayman Khalil, Eoin Fenton, Uchenna Okafo, George Kaar, Michael O’Sullivan,​ and Charles Marks. 2012. “A Prospective Randomised Study to Compare the Utility and Outcomes of Subdural and Subperiosteal Drains for the Treatment of Chronic Subdural Haematoma.” Acta Neurochirurgica (August 30). doi:​10.1007/​s00701-012-1483-1. http://​www.ncbi.nlm.nih.gov/​pubmed/​22932864.
 +
 +Kansal, Ritesh, Trimurti Nadkarni, y Atul Goel. 2010. Single versus double burr hole drainage of chronic subdural hematomas. A study of 267 cases. Journal of Clinical Neuroscience:​ Official Journal of the Neurosurgical Society of Australasia (Marzo 2). doi:​10.1016/​j.jocn.2009.07.109. http://​www.ncbi.nlm.nih.gov/​pubmed/​20202850.
 +
 +Karibe, Hiroshi, Motonobu Kameyama, Makoto Kawase, Takayuki Hirano, Tomohiro Kawaguchi, and Teiji Tominaga. 2011. “[Epidemiology of chronic subdural hematoma].” No Shinkei Geka. Neurological Surgery 39 (12) (December): 1149-1153.
 +
 +Nagatani, Kimihiro, Kojiro Wada, Satoru Takeuchi, and Hiroshi Nawashiro. 2012. “Corticosteroid Suppression of Vascular Endothelial Growth Factor and Recurrence of Chronic Subdural Hematoma.” Neurosurgery (January 18). doi:​10.1227/​NEU.0b013e31824ae86a. http://​www.ncbi.nlm.nih.gov/​pubmed/​22262143.
 +
 +Ohba, Shigeo, Yu Kinoshita, Toru Nakagawa, and Hideki Murakami. 2012. “The Risk Factors for Recurrence of Chronic Subdural Hematoma.” Neurosurgical Review (June 14). doi:​10.1007/​s10143-012-0396-z. http://​www.ncbi.nlm.nih.gov/​pubmed/​22696158.
 +
 +Reichman, Jordan, Samuel Singer, Babak Navi, Anne Reiner, Kathy Panageas, Philip H Gutin, and Lisa M Deangelis. 2012. “Subdural Hematoma in Patients with Cancer.” Neurosurgery 71 (1) (July): 74–79. doi:​10.1227/​NEU.0b013e3182517938.
 +
 +Rust, Tilmann, Nicole Kiemer, and Albert Erasmus. 2006. “Chronic Subdural Haematomas and Anticoagulation or Anti-thrombotic Therapy.” Journal of Clinical Neuroscience:​ Official Journal of the Neurosurgical Society of Australasia 13 (8) (October): 823–827. doi:​10.1016/​j.jocn.2004.12.013.
 +
 +Schievink, Wouter I, M Marcel Maya, Brian K Pikul, and Charles Louy. 2010. “Spontaneous Spinal Cerebrospinal Fluid Leaks as the Cause of Subdural Hematomas in Elderly Patients on Anticoagulation.” Journal of Neurosurgery 112 (2) (February): 295–299. doi:​10.3171/​2008.10.JNS08428.
 +
 +Smith, Matthew D, Lyudmila Kishikova, and Joseph M Norris. 2012. “Surgical Management of Chronic Subdural Haematoma: One Hole or Two?” International Journal of Surgery (London, England) (August 20). doi:​10.1016/​j.ijsu.2012.08.005. http://​www.ncbi.nlm.nih.gov/​pubmed/​22917836.
 +
 +Vladislav, Pavlov, George Bernard, and Salvatore Chibbaro. 2012. “Chronic Subdural Haematoma Management: An Iatrogenic Complication. Case Report and Literature Review.” BMJ Case Reports 2012. doi:​10.1136/​bcr.12.2011.5397. http://​www.ncbi.nlm.nih.gov/​pubmed/​22669031.
 +
 +Vuk, Antonija, Vladimir Stancić, Goran Rincić, Mario Ledinsky, Ljiljana Grbac, and Nevenka Stancić. 2010. “Nontraumatic Bilateral Subdural Hematoma Caused by Antiaggregation Therapy: Case Report and Review of the Literature.” Acta Clinica Croatica 49 (2) (June): 163–168.
 +
 +Zarkou, Srijana, Maria I Aguilar, Naresh P Patel, Kay E Wellik, Dean M Wingerchuk, and Bart M Demaerschalk. 2009. “The role of corticosteroids in the management of chronic subdural hematomas: a critically appraised topic.” The Neurologist 15 (5) (September):​ 299-302. doi:​10.1097/​NRL.0b013e3181b65558.
 +
 +Zingale, A, S Chibbaro, A Florio, G Distefano, and S Porcaro. 1999. “Management of Chronic Subdural Hematoma in Patients Treated with Anticoagulation.” Journal of Neurosurgical Sciences 43 (4) (December): 277–284.
 +
 +**Bibliografía recomendada**
 +
 +Bibliografía ​
 +
 +1.-Arbit Ehud, Patterson RH, Fraser R. An Implantable Subdural Drain for Treatment of Chronic Subdural Hematoma. Surg Neurol 1981; 15:175-177.
 +
 +2. Hernández JE, Gómez A A, Gómez LLS, Humberto MJ. Tratamiento del hematoma subdural crónico con tres técnicas quirúrgicas,​ coagulación y fibrinolisis. Arch Neurocien (Mex) 1997; 2:289-93.
 +
 +3. Laumer R, Schramm J, Leykauf K. Implantation of a Reservoir for Recurrent Subdural Hematoma Drainage. Neurosurg 1989; 25:991-6.
 +
 +4. Markwalder TM. Chronic Subdural Hematomas: a review. J. Neurosurg 1981; 54:637-45.
 +
 +5. Markwalder TM, Seiler RW. Chronic Subdural Hematomas: To Drain or not to Drain?. Neurosurg 1985; 16:185-8.
 +
 +6. Markwalder TM, Steinsiepe KF, Rohner M. Reichenbach W, Markwalder H. The course of chronic subdural hematomas after burr-hole craniostomy and closed - system drainage. J. Neurosurg 1981; 55:390-6.
 +
 +7. Naganuma H, Fukamachi A, Kawakami M, Misumi S, Nakajima A, Wakao T. Spontaneous Resolution of Chronic Subdural Hematoma. Neurosurg 1986; 19:794-8.
 +
 +8. Probst C. Peritoneal drainage of chronic subdural hematomas in older patients. J Neurosurg 1988; 68:908-11.
 +
 +9. Richter HP, Klein HJ, Schafer M. Chronic Subdural Haematoma Treated by Enlarged Burr-Hole Carniotomy and Closed System Drainage. Retrospective Study of 120 Patients. Acta Neurochirurg 1984; 71:179-88.
 +
 +10. Robinson R G. Chronic Subdural Hematoma: Surgical Management in 133 Patients. J Neurosurg 1984; 61:263-8.
 +
 +11. Tabaddor K, Shulman K. Definitive Treatment of Chronic Subdural Hematoma by Twist-drill Craniostomy and Closed - System Drainage. J Neurosurg 1977; 46:220-6.
 +
 +12. Tsutsumi K, Maeda K, Lijma A, Usui M, Okada Y, Kirino T. The relationship of Preoperative Magnetic Resonance Imaging Findings and Closed System Drainage in the recurrence of Chronic Subdural Hematoma. J Neurosurg 1997; 87:870-5.
 +
 +13. Tyson G, Strachan We, Newman P, Winn HR, Butler A, Jane J. The Role of Craniectomy in the Treatment of Chronic Subdural Hematomas. J Neurosurg 1980; 52:776-81.
 +
 +14. Wakai S, Hashimoto K, Watanabe N, Inoh S, Ochiai C, Nagai M. Efficacy of Closed-System Drainage in Treating Chronic Subdural Hematoma: A Prospective Comparative Study. Neurosurg 1990; 26:771-3.
  
  
hematoma_subdural_cronico.txt · Última modificación: 2019/06/18 21:03 por administrador