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J Neurol Sci 2020 Jun 26;416:116997. Epub 2020 Jun 26.

Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.

Objective: To determine if pooled estimates of the prevalence of unexpected findings in patients with headache and normal neurologic examination support current expert opinion-based neuroimaging guidelines.

Methods: We searched PubMed and EMBASE for studies reporting neuroimaging findings in patients with headache and normal neurologic examination up to September 30, 2017. The overall and disease-specific prevalence of unexpected findings were pooled through random-effects meta-analysis. Read More

Eurasian J Med 2020 Jun 9;52(2):211-216. Epub 2020 Jun 9.

Department of Medicine - DIMED, University of Padova Section of Anesthesiology and Intensive Care, Padova, Italy.

Spinal hematoma following neuraxial or perineural techniques is a rare but severe complication that can potentially lead to catastrophic consequences. The aim of this review is to analyze all reported cases of neuraxial or perineural bleeding after performance of a locoregional technique since the last guidelines update in 2018. We included articles indexed by MEDLINE, Scopus, and Google Scholar. Read More

Acta Neurochir (Wien) 2020 Jun 27. Epub 2020 Jun 27.

Department of Neurosurgery, Rigshospitalet, 2092, Blegdamsvej 9, 2100, Copenhagen Ø, DK, Denmark.

Introduction: Chronic subdural hematomas (CSDH) show different radiological characteristics on CT scans at the time of diagnosis. The reason for this is largely unknown. We hypothesize that the imaging characteristics reflect a time-linked pathophysiological evolution. Read More

Eur J Trauma Emerg Surg 2020 Jun 27. Epub 2020 Jun 27.

Department of Neurosurgery, University Hospital Heidelberg, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.

Purpose: The incidence of acute subdural hematomas (aSDH) is rising. However, beneficial effects of surgery for the oldest aSDH patients remain unclear. We hence describe the postoperative outcome of octa- and nonagenarians with aSDH in comparison to a younger patient cohort. Read More

Intern Med 2020 Jun 23. Epub 2020 Jun 23.

Department of Neurology, Tokyo Teishin Hospital, Japan.

Spontaneous intracranial hypotension (SIH) is an important cause of headache mainly associated with spinal cerebrospinal fluid leakage. We herein report the case of a 51-year-old man who developed SIH after swimming. Brain magnetic resonance imaging (MRI) showed a transient high-intensity lesion in the splenium of the corpus callosum (SCC), in addition to bilateral subdural hematomas (SDH) and pseudo-subarachnoid hemorrhage on brain computed tomography. Read More

No Shinkei Geka 2020 Jun;48(6):521-526

Department of Neurosurgery, Iwate Medical University School of Medicine.

Second impact syndrome occurrs when a patient who has sustained an initial head injury, most often a concussion, sustains a second head injury before the symptoms associated with the first have fully resolved, leading to rapid brain swelling and herniation. However, the underlying pathophysiology remains unclear. We report two cases in which acute subdural hematoma with rapid malignant brain swelling developed after repeated head traumas while snowboarding. Read More

Childs Nerv Syst 2020 Jun 20. Epub 2020 Jun 20.

Departments of Pediatric Surgery and Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.

Subdural hematomas with mass effect and midline shift are typically offered urgent surgical evacuation. The authors report a 6-month-old baby who was referred for macrocephaly and found to have a large subdural hematoma with midline shift. Given her lack of symptoms and normal neurological examination, the patient was observed without neurosurgical intervention. Read More

World Neurosurg 2020 Jun 16. Epub 2020 Jun 16.

Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address:

Background: Andexanet alfa, a novel anticoagulation reversal agent for Factor Xa inhibitors, was recently approved. Traumatic intracranial hemorrhage presents a prime target for this drug. The ANNEXA-4 study established the efficacy of andexanet alfa in reversing Factor Xa inhibitors. Read More

Acta Neurochir (Wien) 2020 Jun 18. Epub 2020 Jun 18.

Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, W1B 3GG, UK.

Background: Midline shift in trauma relates to the severity of head injury. Large craniectomies are thought to help resolve brain shift but can be associated with higher rates of morbidity. This study explores the relationship between craniectomy size and subtemporal decompression for acute subdural haematomas with the resolution of brain compression and outcomes. Read More

Biomech Model Mechanobiol 2020 Jun 13. Epub 2020 Jun 13.

Department of Neurosurgery, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium.

Bridging veins (BVs) drain the blood from the cerebral cortex into dural sinuses. BVs have one end attached to the brain and the other to the superior sagittal sinus (SSS), which is attached to the skull. Relative movement between these two structures can cause BV to rupture producing acute subdural haematoma, a head injury with a mortality rate between 30 and 90%. Read More

BMC Neurol 2020 Jun 4;20(1):228. Epub 2020 Jun 4.

Department of Neurology, Saitama Medical University, 38 Morohongo Moroyama, Iruma-gun, Saitama, 350-0495, Japan.

Background: Recent studies have examined hypertrophic pachymeningitis as an IgG4-RD. However, there are no reports of immunoglobulin G4 (IgG4)-related hypertrophic pachymeningitis with polycystic subdural hygroma.

Case Presentation: A 56-year-old man presented to the hospital with complaints of a persistent, pulsatile, occipital headache and general malaise. Read More

Surg Neurol Int 2020 2;11:89. Epub 2020 May 2.

Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku.

Background: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions, with different strategies for treatment. Most recent trials favor the use of drainage to reduce the recurrence rate. However, few reports have discussed the efficacy of burr hole drainage without irrigation for treating CSDH. Read More

Medicine (Baltimore) 2020 May;99(21):e20200

Division of Neurology, University of Alberta Hospital, Alberta, Canada.

Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage.

Patient Concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. Read More

Brain Res 2020 Sep 20;1742:146901. Epub 2020 May 20.

Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, PR China; Department of Neurosurgery, 900th Hospital, Fuzhou, PR China. Electronic address:

Mass evacuation with decompressive craniotomy is considered a standard intervention for acute subdural hematoma (ASDH). However, hemispheric swelling complicates the intraoperative and postoperative management of ASDH patients, and previous studies have revealed that this approach can damage ischemic/reperfusion (I/R) injury. Few studies have focused on the cerebrovascular response following traumatic brain injury (TBI). Read More

No Shinkei Geka 2020 May;48(5):413-422

Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center.

A 68-year-old male with a sudden headache while defecation was transferred to our hospital. He was initially diagnosed with intracerebral hemorrhage in the right occipital lobe and acute subdural hematoma(ASDH)in the right interhemispheric fissure. A CT angiography(CTA)showed stenosis in the superior sagittal sinus(SSS)and the vein of Galen(VG)near the hematoma, which were considered to be due to compression of the hematoma. Read More

Acta Neurochir (Wien) 2020 Jul 20;162(7):1495-1499. Epub 2020 May 20.

Neurospinal Hospital, Dubai, United Arab Emirates.

The coronavirus pandemic that started in December 2019 is mainly related to clinical pictures consistent with respiratory symptoms; nevertheless, reports about neurological complications have recently appeared in the medical literature. We describe a case of a 36-year-old coronavirus-positive patient that was admitted on emergency basis; his clinical presentation included neurological symptoms such as drowsiness and mild confusion. Imaging revealed findings consistent with meningoencephalitis complicated by intracerebral hematoma and subdural hematoma. Read More

World Neurosurg 2020 May 12;140:219-223. Epub 2020 May 12.

Department of Neurosurgery, Rouen University Hospital, Rouen, France; Department of Interventional Neuroradiology, Rouen University Hospital, Rouen, France; University of Limoges CNRS XLIM UMR 7252, Limoges, France; Laboratory of Microvascular Endothelium and Neonate Brain Lesions, Normandie University, UNIROUEN, INSERM U1245, Rouen, France. Electronic address:

Background: Intracranial aneurysms (IAs) are exceptional in neonates accounting for less than 2% of all IAs occurring during the first decade of life. Little is known about this pathology in this specific population. Because of its scarcity and this specific age at onset, the treatment of IA in neonates is challenging. Read More

J Clin Neurosci 2020 Jul 8;77:110-115. Epub 2020 May 8.

Department of Radiology, Seoul National University Bundang Hospital, Republic of Korea.

Heavily T2-weighted MR myelography (HT2W-MRM) is emerging as an alternative approach for detection and follow up of CSF leaks. We aimed to assess epidural blood patch (EBP) treatment outcome when using HT2W-MRM as the primary modality for detecting CSF leak and planning EBP placement in routine clinical practice. Since 2018, patients at our institute suspected of having CSF leak, routinely HT2W-MRM instead of CT myelography to determine presence of the leak and identify the EBP target site. Read More

Medicine (Baltimore) 2020 May;99(19):e20032

Departments of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Japan.

Rationale: Spontaneous spinal subdural hematoma (SSDH) is a rare disease that can cause severe permanent neurological dysfunction. Here we present a case of spontaneous SSDH, in which a series of magnetic resonance images (MRIs) taken through the course of the disease facilitated understanding of the resolution process of the hematoma and the diagnosis of SSDH.

Patient Concerns: A 59-year-old male presented with sudden severe back pain and rapid onset of paraplegia. Read More

Acta Vet Hung 2020 May 6. Epub 2020 May 6.

3National Institute of Clinical Neurosciences, Budapest, Hungary.

In this study we described two different indications of ventriculo- and cystoperitoneal shunting (VPS, CPS) procedures in six dogs, including their clinical data and magnetic resonance imaging (MRI) examinations. One dog had moderate and two dogs had severe congenital hydrocephalus, one was presented with intracranial pressure elevation due to meningoencephalitis of unknown origin (MUO) associated with congenital hydrocephalus, and two with quadrigeminal cysts (QC). VPS procedures were done in four and CPS in two dogs, using low-pressure valve systems. Read More

World Neurosurg 2020 Apr 25;139:440-444. Epub 2020 Apr 25.

Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan.

Background: Cerebrospinal fluid (CSF) drainage during the treatment of aortic disease is commonly performed to prevent spinal cord ischemia. Spinal subdural hematoma (SDH) has never been reported after CSF drainage during thoracic endovascular aortic repair (TEVAR). We present a case of concurrent intracranial subarachnoid hemorrhage (SAH) and spinal SDH after CSF drainage tube removal in a patient with TEVAR. Read More

Acta Neurochir (Wien) 2020 Jun 27;162(6):1455-1466. Epub 2020 Apr 27.

Translational Neurosurgery, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Background: Drain insertion following chronic subdural haematoma (CSDH) evacuation reduces recurrence and improves outcomes. The mechanism of this improvement is uncertain. We assessed whether drains result in improved postoperative imaging, and which radiological factors are associated with recurrence and functional outcome. Read More

Neurol Sci 2020 Apr 27. Epub 2020 Apr 27.

School of Medicine and Health Sciences, Tecnologico de Monterrey Campus Guadalajara, Zapopan, Mexico.

Spontaneous intracranial hypotension (SIH) is a rare neurological condition caused by low cerebrospinal fluid (CSF) volume, most commonly due to a CSF leak. The most common presenting symptom is an orthostatic headache, but some patients may present with atypical neurological manifestations such as cranial nerve palsies, an altered mental status, and movement disorders, which complicate the clinical diagnosis. Therefore, the diagnosis is based on the combination of clinical signs and symptoms, neuroimaging, and/or a low cerebrospinal fluid pressure. Read More

Biomed J 2020 Apr 21. Epub 2020 Apr 21.

Department of Pediatrics, Fu Jen Catholic University Hospital, New Taipei City, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan. Electronic address:

Abusive head trauma (AHT), used to be named shaken baby syndrome, is an injury to the skull and intracranial components of a baby or child younger than 5 years due to violent shaking and/or abrupt impact. It is a worldwide leading cause of fatal head injuries in children under 2 years. The mechanism of AHT includes shaking as well as impact, crushing or their various combinations through acceleration, deceleration and rotational force. Read More

BMC Neurol 2020 Apr 23;20(1):151. Epub 2020 Apr 23.

Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo, 136-0075, Japan.

Background: Intracranial hypotension is a disorder characterized by low cerebrospinal fluid (CSF) pressure typically caused by loss of CSF. Although some mechanisms account for the CSF leakage have been elucidated, spinal canal stenosis has never been reported as a pathological cause of intracranial hypotension. C1-C2 sign is a characteristic imaging feature, which indicates CSF collection between the spinous processes of C1 and C2, occasionally observed on magnetic resonance imaging (MRI) in patients with intracranial hypotension. Read More

World Neurosurg 2020 Apr 18;139:196-199. Epub 2020 Apr 18.

Department of Neurosurgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.

Background: Incidence of chronic subdural hematoma (CSH) associated with metastases of extraneural malignancies is rare. We report a rare case of CSH wherein most of the CSH cavity was occupied with metastatic cancer cells; in addition, we review the literature.

Case Description: A 68-year-old man with a history of gastric cancer presented to our hospital with dysarthria and shoulder paralysis; CSH was diagnosed from preoperative imaging findings. Read More

World Neurosurg 2020 Apr 13. Epub 2020 Apr 13.

Department of Neurosurgery, New York University School of Medicine, New York, New York, USA. Electronic address:

Objective: Middle meningeal artery (MMA) embolization could be an effective method of inhibiting neovascularization of the subdural capsular membrane and preventing hematoma maintenance. We sought to better understand how the MMA might affect subdural hematoma physiology and how this process might be modified by embolization.

Methods: We performed a retrospective review of 27 patients with 29 subdural hematomas (SDHs) who had undergone MMA embolization from July 2018 to May 2019. Read More

Clin Neurol Neurosurg 2020 Jul 8;194:105831. Epub 2020 Apr 8.

Department of Neurosurgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.

Objectives: Infected subdural hematoma (ISH) is a rare type of subdural empyema, with fewer than 50 cases reported to date. Its radiological features have not been adequately described, making diagnosis challenging. At our institution, two adults presented with ISH, which exhibited a characteristic shape on preoperative imaging. Read More

Am J Phys Med Rehabil 2020 Apr 9. Epub 2020 Apr 9.

Department of Rehabilitation Medicine, University of Washington, Seattle, WA.

CASE 1: 9 year old boy presents with right subdural hematoma and ipsilateral hemiparesis. Clinical presentation and imaging is consistent with Kernohan-Woltman Notch Phenomenon. CASE 2: 19 year old male presents with right subdural hematoma and ipsilateral hemiparesis. Read More

Radiol Case Rep 2020 Jun 5;15(6):668-671. Epub 2020 Apr 5.

Department of Neurosurgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, Iwate 024-8507, Japan.

Paroxysmal homonymous hemianopsia (HH) is uncommon presentation of epilepsy. We demonstrate a rare case of paroxysmal HH that was diagnosed by magnetic resonance (MR) arterial spin-labeling (ASL). A 82-year-old woman presented with abrupt onset of isolated visual field abnormality without convulsive epilepsy at 16 days after a traumatic head injury. Read More

World Neurosurg 2020 Apr 6. Epub 2020 Apr 6.

Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA. Electronic address:

Objective: Subdural hematoma (SDH), a form of traumatic brain injury, is a common disease that requires extensive patient management and resource utilization; however, there remains a paucity of national studies examining the likelihood of readmission in this patient population. The aim of this study is to investigate differences in 30- and 90-day readmissions for treatment of traumatic SDH using a nationwide readmission database.

Methods: The Nationwide Readmission Database years 2013-2015 were queried. Read More

World Neurosurg 2020 Apr 6. Epub 2020 Apr 6.

Departments of Neurological Surgery, Radiology, Mechanical Engineering, and Stroke and Applied Neuroscience Center, University of Washington, Seattle, Washington, USA. Electronic address:

Objective: Acute subdural hematoma (aSDH) is a common pathology encountered in neurosurgery. Although most cases are associated with trauma and injuries to draining veins, traumatic aSDH from injury to arteries or spontaneous aSDH because of a ruptured intracranial aneurysm can occur. For some patients without a clear clinical history, it can be difficult to distinguish between these etiologies purely based on radiography. Read More

BMC Musculoskelet Disord 2020 Apr 3;21(1):204. Epub 2020 Apr 3.

Division of Endocrinology and Metabolism, Department of Medicine, the Institute for Human Genetics; and the Program in Craniofacial Biology - University of California, San Francisco, 513 Parnassus Ave., HSE901, San Francisco, CA, 94143-0794, USA.

Background: Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare disorder marked by painful, recurrent flare-ups and heterotopic ossification (HO) in soft and connective tissues, which can be idiopathic or provoked by trauma, illness, inflammation, or surgery. There are currently no effective treatments for FOP, or for patients with FOP who must undergo surgery. Palovarotene, an investigational retinoic acid receptor-γ agonist, offers a potential avenue to prevent HO formation. Read More

Mol Imaging 2020 Jan-Dec;19:1536012120914773

Division of Neurosurgery, Department of Surgery, Kuang Tien General Hospital, Taichung, Taiwan.

Chronic subdural hematomas (CSDHs) frequently affect the elderly population. The postoperative recurrence rate of CSDHs is high, ranging from 3% to 20%. Both qualitative and quantitative analyses have been explored to investigate the mechanisms underlying postoperative recurrence. Read More

World Neurosurg 2020 Jun 23;138:313-316. Epub 2020 Mar 23.

Department of Neurological Surgery, Northwestern Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, Illinois, USA. Electronic address:

Background: Autologous bone resorption is a frequent complication of cranioplasty, often necessitating reoperation. The etiology of this phenomenon is unknown, although it has recently been associated with indolent Propionibacterium acnes infection.

Case Description: A 59-year-old man initially presented with a traumatic acute subdural hematoma treated with emergent decompressive hemicraniectomy and hematoma evacuation. Read More

Cureus 2020 Feb 17;12(2):e7018. Epub 2020 Feb 17.

Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana, USA.

Spontaneous intracranial hypotension (SIH) is a pathology characterized by orthostatic headaches, diffuse pachymeningeal enhancement on magnetic resonance imaging (MRI), and low to normal cerebrospinal fluid (CSF) pressures. We present the case of a 46-year-old male with refractory postural headaches, found to have a diffuse CSF leak throughout the cervicothoracic (C1-T12) spine. His neurological status declined rapidly to a Glasgow Coma Scale (GCS) of eight, necessitating bilateral subdural drain placement. Read More

Neurocrit Care 2020 Mar 23. Epub 2020 Mar 23.

Department of Intensive Care Medicine, Fundación Valle del Lili, Carrera 98 #18-49, Cali, Colombia.

Background: Literature on diabetes insipidus (DI) after severe traumatic brain injury (TBI) is scarce. Some studies have reported varying frequencies of DI and have showed its association with increased mortality, suggesting it as a marker of poor outcome. This knowledge gap in the acute care consequences of DI in severe TBI patients led us to conceive this study, aimed at identifying risk factors and quantifying the effect of DI on short-term functional outcomes and mortality. Read More

BMC Neurol 2020 Mar 18;20(1):102. Epub 2020 Mar 18.

Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, P.O. Box: 4398, Al-Khobar City, Eastern Province, 31952, Saudi Arabia.

Background: Ruptured intracranial aneurysms are often associated with subarachnoid or intraparenchymal hemorrhage. However, the prevalence of subdural hemorrhage post aneurysmal rupture is low and rarely reported in scientific studies. Here, we report an unusual case of a ruptured posterior communicating artery aneurysm resulting in an isolated subdural hematoma located in the tentorial and spinal canal without subarachnoid or intraparenchymal hemorrhage. Read More

Int J Neurosci 2020 Mar 23:1-6. Epub 2020 Mar 23.

Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

Non-traumatic spontaneous acute epidural hematoma (EDH) happening to chronic subdural hematoma (SDH) caused by dural metastases is a rare entity. Pathogenesis can be derived from infection, coagulopathy, and inflammation. Malignant tumors metastasize to dura mater is one of the most infrequent causes. Read More

Case Rep Womens Health 2020 Apr 20;26:e00183. Epub 2020 Feb 20.

Department of Obstetrics and Gynecology, University Hospital, University of Duisburg-Essen, Essen, Germany.

A fetal subdural hematoma (SDH) was diagnosed in a patient with sickle cell disease (SCD) during a routine ultrasound exam in the 30th week of pregnancy. A scan performed a few days earlier had revealed no abnormalities. After interdisciplinary consultation with neurosurgeons and neonatologists, a cesarean section was performed since acute subdural bleeding was hypothesized and the mother's condition was critical. Read More

Front Neurol 2020 20;11:118. Epub 2020 Feb 20.

Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, United States.

Abusive head trauma (AHT) is broadly defined as injury of the skull and intracranial contents as a result of perpetrator-inflicted force and represents a persistent and significant disease burden in children under the age of 4 years. When compared to age-matched controls with typically single occurrence accidental traumatic brain injury (TBI), mortality after AHT is disproportionately high and likely attributable to key differences between injury phenotypes. This article aims to review the epidemiology of AHT, summarize the current state of AHT diagnosis, treatment, and prevention as well as areas for future directions of study. Read More

Cureus 2020 Jan 22;12(1):e6743. Epub 2020 Jan 22.

Radiology, Atlantic Medical Imaging, Galloway, USA.

A spinal subdural hematoma is a rare clinical entity and an uncommon urgent complication that can be associated with the use of vitamin K and less commonly nonvitamin K oral anticoagulants. It is considered a neurological emergency requiring prompt diagnosis and surgical intervention in the majority of the cases. Herein, we present an 84-year-old male patient with a history of nonvalvular atrial fibrillation on apixaban who presented with complaints of bilateral lower extremity weakness, severe back pain, and urinary retention. Read More

Int J Surg 2020 Apr 17;76:88-92. Epub 2020 Feb 17.

Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Background: Patients with mild traumatic brain injury (mTBI) are frequently transferred to level 1 trauma centers (L1TC) if they have minor findings on a computerized tomographic scan of the head due to the absence of continuous neurosurgical coverage in community hospitals (CH). We hypothesized that such patients can be safely managed at community hospitals with a qualified Trauma team.

Methods: This is a multicentered Retrospective Cohort Study. Read More

Neurocrit Care 2020 04;32(2):407-418

Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Background: With increasing use of direct oral anticoagulants (DOACs) and availability of new reversal agents, the risk of traumatic intracranial hemorrhage (tICH) requires better understanding. We compared hemorrhage expansion rates, mortality, and morbidity following tICH in patients treated with vitamin k antagonists (VKA: warfarin) and DOACs (apixaban, rivaroxaban, dabigatran).

Methods: Retrospective chart review of patients from 2010 to 2017 was performed to identify patients with imaging diagnosis of acute traumatic intraparenchymal, subdural, subarachnoid, and epidural hemorrhage with preadmission use of DOACs or VKAs. Read More

World Neurosurg 2020 May 4;137:350-356. Epub 2020 Feb 4.

Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Background: Chronic subdural hematoma evacuation can be achieved in select patients through bedside placement of the Subdural Evacuation Port System (SEPS; Medtronic, Inc., Dublin, Ireland). This procedure involves drilling a burr hole at the thickest part of the hematoma. Read More

Br J Neurosurg 2020 Jan 29:1-6. Epub 2020 Jan 29.

Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China.

Patients with subdural hygroma (SDG) are at increased risk of developing chronic subdural hematoma (CSDH). However, the factors that increase the risk of conversion are not fully understood. This study was to assess the risk factors of SDG conversion to CSDH. Read More

Clin Neurol Neurosurg 2020 Apr 15;191:105682. Epub 2020 Jan 15.

Department of Neurosurgery, Caen University Hospital, Avenue de la Côte de Nacre, CHU Caen, 14033, Caen, France; Physiopathology and Imaging of Neurological Disorders (PhIND), Normandie Université, UNICAEN, INSERM, UMR-S U1237, GIP Cyceron, 14000, Caen, France. Electronic address:

Objectives: The aims of the present study were to evaluate the frequency of late recurrence after chronic subdural hematoma (CSDH) evacuation and to examine the interest in the use of a systematic CT scan within the first two months after surgery.

Patients And Methods: We performed a retrospective study that included all patients who underwent CSDH evacuation between 2007 and 2017. We evaluated the rate of late recurrence, defined as the need to perform a new surgery after the first month of follow-up. Read More

Sci Rep 2020 Jan 24;10(1):1145. Epub 2020 Jan 24.

Department of Neurosurgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

Recurrence of chronic subdural hematoma (CSDH) frequently occurs after surgical evacuation. However, the value of follow-up postoperative imaging and measuring volumetric factors to predict recurrence are still controversial. Herein, we aimed to assess the optimal timing for follow-up referential imaging and the critical depressed brain volume for CSDH recurrence. Read More

Surg Neurol Int 2020 17;11. Epub 2020 Jan 17.

Department of Neurosurgery, Hospital das Clinicas da Faculdade de Medicina da USP, Sao Paulo, Brazil.

Background: Acute spontaneous subdural hematoma is rare. For patients under 40 years of age, we found only five previous reports. Here, we have presented a sixth case study. Read More

J Surg Res 2020 May 8;249:99-103. Epub 2020 Jan 8.

Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania.

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. Read More