The Comparison Between Surgical Procedure and Conservative Treatment in the Management of Traumatic Subdural Effusion

Objective & Hypothesis:AIM: Traumatic subdural effusion (TSE) occurs following traumatic brain injury and may be treated by either conservative methods or surgical procedure commonly according to the patients' clinical information.

📊

Key Findings & Data:We aimed to compare the effective rate of effusion removal and the standardized morbidity ratio of poor prognosis of the two different treatments, and to discuss the future treatment methods possible.

💡

Conclusion & Impact:Adequate evidence is required to clear the indications.

🔬Design:Review & Systematic Survey

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Özet

AIM: Traumatic subdural effusion (TSE) occurs following traumatic brain injury and may be treated by either conservative methods or surgical procedure commonly according to the patients' clinical information. We aimed to compare the effective rate of effusion removal and the standardized morbidity ratio of poor prognosis of the two different treatments, and to discuss the future treatment methods possible. MATERIAL and METhODS: We reviewed the clinical records of patients who were divided into two groups according to the treatment choices in our center, and the effective rate of effusion removal and the standardized morbidity ratio of poor prognosis were compared. RESULTS: Eighty patients were identified, and divided into two groups: conservative treatment and surgical procedure group. The mean CRASH-CT predicted risk of mortality in two weeks and unfavorable outcome at six months was higher in the surgical procedure group compared with the conservative treatment group.Effective rate of effusion removal was observed in 57.1 % of conservative treatment group versus 88.5% of surgical procedure group (p=0.002). The standardized morbidity ratio of poor prognosis (observed/expected poor prognosis) was 0.56 (95 % CI: 0.32-0.80) for the conservative treatment group versus 0.25 (95 % CI: 18 0.08-0.42) for the surgical procedure group.CONCLUSION: Conservative treatment and surgical procedure are used for the management of traumatic subdural effusion, and the former is used more commonly to treat the mildly affected patients than the latter one, but a surgical procedure may be more effective for the patients in poor clinical condition. Adequate evidence is required to clear the indications.

🔖

Cite This Article

XIE, D., XIE, J., WAN, Y., QI, X., YANG, S. (2016). The Comparison Between Surgical Procedure and Conservative Treatment in the Management of Traumatic Subdural Effusion. Turkish Neurosurgery, Cilt: 26 - Sayı: 5, 725–731. https://ajindex.com/articles/417691

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (1)

Borzone M, Capuzzo T, Perria C, Rivano C, Tercero E: Traumatic subdural hygromas: A report of 70 surgically treated cases. J Neurosurg Sci 27(3):161-165, 1983 2. Caldarelli M, Dirocco C, Romani R: Surgical treatment of chronic subdural hygromas in infants and children. Acta Neurochir 144(6):581-588,2002 3. Collaborators CT. Available at: http://www.crash.lshtm.ac.uk/ Risk%20calculator/index.html Accessed November 24, 2010 4. Herold TJ1, Taylor S, Abbrescia K, Hunter C: Post-traumatic subdural hygroma: Case report. J Emerg Med 27(4):361-366, 2004 5. Jaccard E, de Tribolet N: Post-traumatic subdural hygroma. Neurochirurgie 29(5):333-338,1983 6. John JN, Dila C: Traumatic subdural hydroma in adults. Neurosurgery 9:621-625, 1981 7. Kumar R, Singhal N, Mahapatra AK: Traumatic subdural effusions in children following minor head injury. Childs Nerv Syst 24:1391-1396, 2008 8. Lee KS: The pathogenesis and clinical significance of traumatic subdural hygroma. Brain Inj 12:595-603, 1998 9. Lee KS, Bae WK, Gun H, Yun IG: The fate of traumatic subdural hygroma in serial computed tomographic scans. J Korean Med Sci 15:560-568, 2000 10. Litofsky NS, Raffel C, Mc Comb JG: Management of symptomatic chronic extra-axial fluid collections in pediatric patients. Neurosurgery 21(3):445-450, 1992 11. Liu Y, Gong J, Li F, Wang H, Zhu S, Wu C: Traumatic subdural hydroma: Clinical characteristics and classification. Injury 40: 968-972, 2009 12. Masuzawa T, Kumagai M, Sato F: Computed tomographic evolution of post-traumatic subdural hygroma in young adults. Neuroradiology 26(3):245-248, 1984 13. Murata K: Chronic subdural hematoma may be preceded by persistent traumatic subdural effusion. Neuros Med Chir 33: 691-696, 1993 14. Perel P, Arango M, Clayton T, Edwards P, Komolafe E, Poccock S: Predicting outcome after traumatic brain injury: Practical prognostic models based on large cohort of international patients. BMJ 336:425-429, 2008 15. Sonmez OF, Temel Y, Visser-Vandewalle V, Sahin B, Odacı E: A new evaluation method for the intracranial volume changes and subdural effusion of patients following endoscopic third ventriculostomy. Clin Neurol Neurosurg 115:160-164, 2013 16. Todorow S, Happe M: Traumatic subdural hygromas. Neurochirurgia (Stuttg) 24(4):131-136, 1981 17. Tsuang FY, Huang APH, Tsai YH, Chen JY, Lee JE, Tu Y K, Wang KC: Treatment of patients with traumatic subdural effusion and concomitant hydrocephalus. J Neurosurg 116:558-565, 2012 18. von Elm E, Altman DG, Egger M,