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Published on: October 2, 2014
Subdural hematoma in regularly hemodialyzed patients
Annals of Internal Medicine
|May 1, 1975
Summary
Subdural hematoma occurred in 3.3% of dialysis patients, linked to head trauma, hypertension, and anticoagulants. Diagnosis was challenging, with poor outcomes following surgery.
Area of Science:
- Nephrology
- Neurology
- Radiology
Background:
- Subdural hematoma is a serious complication in patients undergoing regular dialysis.
- Identifying risk factors and diagnostic methods is crucial for patient outcomes.
Purpose of the Study:
- To determine the incidence of subdural hematoma in dialysis patients.
- To identify associated risk factors and evaluate diagnostic modalities.
- To assess the effectiveness of surgical intervention.
Main Methods:
- Retrospective analysis of 394 dialysis patients.
- Review of medical records for subdural hematoma development.
- Evaluation of diagnostic tools including imaging and angiography.
- Analysis of surgical outcomes and literature review.
Main Results:
- Thirteen of 394 (3.3%) dialysis patients developed subdural hematoma.
- Associated factors included head trauma, ultrafiltration, hypertension, anticoagulants, and vascular access complications.
- Neurologic symptoms were non-specific.
- Skull films, lumbar puncture, and EEG had limited diagnostic value.
- Brain scanning showed false negatives and missed bilateral lesions.
- Cerebral angiography was consistently diagnostic.
- Surgical intervention resulted in a 15% survival rate (2 out of 13 patients).
Conclusions:
- Subdural hematoma is a significant risk in dialysis patients.
- Early identification of risk factors is essential.
- Cerebral angiography is the most reliable diagnostic tool.
- Surgical outcomes are poor, necessitating further research into management strategies.
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