Traumatic Parafalcine Subdural Hematoma: A Clinically Benign Finding.

Autor: Cragun BN; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania. Electronic address: benjamin.cragun@ahn.org., Noorbakhsh MR; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania., Hite Philp F; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania., Suydam ER; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania., Ditillo MF; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania., Philp AS; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania., Murdock AD; Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2020 May; Vol. 249, pp. 99-103. Date of Electronic Publication: 2020 Jan 08.
DOI: 10.1016/j.jss.2019.12.019
Abstrakt: Background: Guidelines for management of intracranial hemorrhage do not account for bleed location. We hypothesize that parafalcine subdural hematoma (SDH), as compared to convexity SDH, is a distinct clinical entity and these patients do not benefit from critical care monitoring or repeat imaging.
Methods: We identified patients presenting to a single level I trauma center with isolated head injuries from February 2016 to August 2017. We identified 88 patients with isolated blunt traumatic parafalcine SDH and 228 with convexity SDH.
Results: Demographics, comorbidities, and use of antiplatelet and anticoagulant agents were similar between the groups. As compared to patients with convexity SDH, patients with parafalcine SDH had a significantly lower incidence of radiographic progression, and had no cases of neurologic deterioration, neurosurgical intervention, or mortality (all P < 0.005). Compared to patients admitted to the intensive care unit, patients with parafalcine SDH admitted to the floor had a shorter length of stay (2.0 ± 1.6 versus 3.8 ± 2.9 d, P < 0.005) with no difference in outcomes.
Conclusions: Patients presenting with a parafalcine SDH are a distinct and relatively benign clinical entity as compared to convexity SDH and do not benefit from repeat imaging or intensive care unit admission.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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