Document Detail


A single center's experience with the bedside subdural evacuating port system: a useful alternative to traditional methods for chronic subdural hematoma evacuation.
MedLine Citation:
PMID:  23259822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Object The traditional methods for managing symptomatic chronic subdural hematoma (SDH) include evacuation via a bur hole or craniotomy, both with or without drain placement. Because chronic SDH frequently occurs in elderly patients with multiple comorbidities, the bedside approach afforded by the subdural evacuating port system (SEPS) is an attractive alternative method that is performed under local anesthesia and conscious sedation. The goal of this study was to evaluate the radiographic and clinical outcomes of SEPS as compared with traditional methods. Methods A prospectively maintained database of 23 chronic SDHs treated by bur hole or craniotomy and of 23 chronic SDHs treated by SEPS drainage at Tufts Medical Center was compiled, and a retrospective chart review was performed. Information regarding demographics, comorbidities, presenting symptoms, and outcome was collected. The volume of SDH before and after treatment was semiautomatically measured using imaging software. Results There was no significant difference in initial SDH volume (94.5 cm(3) vs 112.6 cm(3), respectively; p = 0.25) or final SDH volume (31.9 cm(3) vs 28.2 cm(3), respectively; p = 0.65) between SEPS drainage and traditional methods. In addition, there was no difference in mortality (4.3% vs 9.1%, respectively; p = 0.61), length of stay (11 days vs 9.1 days, respectively; p = 0.48), or stability of subdural evacuation (94.1% vs 83.3%, respectively; p = 0.60) for the SEPS and traditional groups at an average follow-up of 12 and 15 weeks, respectively. Only 2 of 23 SDHs treated by SEPS required further treatment by bur hole or craniotomy due to inadequate evacuation of subdural blood. Conclusions The SEPS is a safe and effective alternative to traditional methods of evacuation of chronic SDHs and should be considered in patients presenting with a symptomatic chronic SDH.
Authors:
Mina Safain; Marie Roguski; Alexander Antoniou; Clemens M Schirmer; Clemens S Schirmer; Adel M Malek; Ron Riesenburger
Publication Detail:
Type:  Journal Article     Date:  2012-12-21
Journal Detail:
Title:  Journal of neurosurgery     Volume:  118     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-04     Completed Date:  2013-04-22     Revised Date:  2013-08-26    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-700     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts 02110, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Craniotomy*
Drainage / instrumentation
Female
Hematoma, Subdural, Chronic / surgery*
Humans
Length of Stay
Male
Medical Records
Middle Aged
Point-of-Care Systems*
Retrospective Studies
Treatment Outcome
Comments/Corrections
Erratum In:
J Neurosurg. 2013 Jul;119(1):256
Note: Schirmer, Clemens S [corrected to Schirmer, Clemens M]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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