Related Experiment Video

Updated: Aug 8, 2026

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
06:18

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury

Published on: March 26, 2019

9.7K

Outcomes of chronic subdural hematoma with preexisting comorbidities causing disturbed consciousness

Yasuaki Abe1, Keisuke Maruyama1, Shigeomi Yokoya1

  • 1Department of Neurosurgery, Kyorin University School of Medicine, Tokyo, Japan.

Journal of Neurosurgery
|May 28, 2016
PubMed

Insights

Preexisting comorbidities significantly worsen outcomes for chronic subdural hematoma (CSDH) patients undergoing surgery. These conditions are linked to aging and impact recovery, increasing morbidity and mortality.

Area of Science:

  • Neurosurgery
  • Geriatric Medicine
  • Neurology

Background:

  • Chronic subdural hematoma (CSDH) is commonly treated surgically via bur hole drainage.
  • The impact of pre-existing comorbidities, particularly those affecting consciousness, on CSDH patient outcomes is not well understood.
  • Understanding these factors is crucial for optimizing surgical treatment and patient management.

Purpose of the Study:

  • To investigate the influence of pre-existing comorbidities causing consciousness disturbance on patient outcomes after CSDH surgery.
  • To analyze the relationship between comorbidities and functional recovery, morbidity, mortality, and recurrence rates.

Main Methods:

  • Retrospective analysis of 188 consecutive CSDH patients treated surgically between 2010-2012.
  • Outcomes assessed included modified Rankin Scale (mRS) score, postoperative morbidity, mortality, and recurrence at 90 days.
  • Patients were stratified based on the presence of comorbidities affecting consciousness (e.g., dementia, stroke history).

Main Results:

  • Patients with comorbidities were older, had lower preoperative Glasgow Coma Scale scores, and higher preoperative mRS scores.
  • A significantly higher mean mRS score at 90 days post-surgery was observed in patients with comorbidities (p < 0.001).
  • Comorbidities, older age, reoperation, and higher preoperative mRS score were independently associated with poor outcomes (mRS ≥ 3).

Conclusions:

  • Pre-existing comorbidities significantly impact the severity and outcomes 90 days after surgical treatment of CSDH.
  • Comorbidities are associated with aging and contribute to poorer functional recovery and increased postoperative morbidity and mortality.
  • Surgical treatment for CSDH in patients with comorbidities requires careful consideration of these factors for improved management.

Keywords:
CSDH = chronic subdural hematomaGCS = Glasgow Coma Scalechronic subdural hematomacomorbidityconsciousness disturbancemRS = modified Rankin Scaleoutcomesurgerytrauma

More Related Videos

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage10:34

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage

Published on: August 30, 2020

11.7K
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model09:14

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

Published on: June 18, 2021

2.9K

Related Concept Videos

Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Dementia l: Introduction01:22

Dementia l: Introduction

Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...