Chronic subdural hematoma in patients over 65 years old: Results of using a postoperative cognitive evaluation to determine whether to permit return to driving
| Autor: | Norio Narita, Kokoro Kawamura, Siqi Cai, Ryuzaburo Kochi, Dan Ozaki, Masahito Katsuki, Ohmi Watanabe, Shinya Shimabukuro, Yuya Kato, Kenichi Yokota, K. Sato, Wenting Jia, Naoya Ishida, Taketo Nishizawa, Yoshimichi Sato, Iori Yasuda |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cognitive evaluation theory
Dysexecutive syndrome medicine.medical_specialty Higher brain dysfunction business.industry Trail Making Test Chronic subdural hematoma medicine.disease Test (assessment) Cognitive assessment Elderly Physical therapy Cutoff Medicine Dementia Surgery Local anesthesia Original Article Neurology (clinical) business Kohs block design test |
| Zdroj: | Surgical Neurology International |
| ISSN: | 2152-7806 2229-5097 |
| Popis: | Background: Chronic subdural hematoma (CSDH) is usually associated with good recovery with burr hole irrigation and postoperative drainage under local anesthesia. In Japan, traffic accidents by the elderly drivers over 65 years old are severely increasing, and there is no consensus on whether or not to return to driving after CSDH treatment. We perform a postoperative cognitive assessment. We retrospectively investigated the return-to-driving rate and associated factors. Methods: Of the 45 patients over 65 y.o. and who had usually driven, 30 patients wished to drive again. We performed tests composed of Mini-Mental State Examination (MMSE), line cancellation and line bisection task, Kohs block design test, trail making test (TMT)-A and B, Kana-hiroi test, Rey-Osterrieth complex figure test, and behavioral assessment of the dysexecutive syndrome, in order. When all tests’ scores were better than the cutoff values, we let patients drive again. When some of the scores were worse than the cutoff values, we reevaluated the patients at the outpatient every month. If the patients’ scores could not improve at the outpatient, we recommended them to stop driving. Results: Nineteen of 30 patients could return to driving. Worse MMSE, Kohs block design test, TMT-A, TMT-B scores, higher age, dementia, or consciousness disturbance as chief complaints were associated with driving disability. Conclusion: CSDH is known as treatable dementia. However, we should perform an objective cognitive assessment before discharge because only 63% of the patients over 65 y.o. who wished to drive could return to driving. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|