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Related Experiment Video

Updated: Jul 10, 2026

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Aneurysmal Subdural Hematoma: A Systematic Review.

Mohammad Aladawi1, Mohamed Elfil1, Zaid R Najdawi1

  • 1Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.

Neurocritical Care
|February 9, 2024
PubMed
Summary

Aneurysmal subdural hematoma (aSDH) is rare but associated with poor outcomes, especially when occurring with aneurysmal subarachnoid hemorrhage (aSAH). Surgical intervention may improve patient outcomes.

Keywords:
Intracranial aneurysmSubarachnoid hemorrhageSubdural hematomaaSAHaSDH

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Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Aneurysmal subdural hematoma (aSDH) is a rare complication of ruptured aneurysms, occurring in 0.5-7.9% of patients with aneurysmal subarachnoid hemorrhage (aSAH).
  • Limited data exists on the clinical presentation, course, and outcomes of patients with aSDH.

Purpose of the Study:

  • To systematically review literature on demographics, clinical presentation, aneurysm location, treatment, and outcomes of patients with aSDH.
  • To compare outcomes between patients with aSDH with and without concurrent aSAH.

Main Methods:

  • Systematic review of PubMed, EMBASE, and Google Scholar following PRISMA guidelines.
  • Data extraction on patient demographics, clinical presentation, imaging, surgical interventions, and outcomes.
  • Statistical comparison of outcomes, surgical treatment needs, and aneurysm location between groups using chi-squared and logistic regression analyses.

Main Results:

  • 112 articles identified, totaling 270 patients (70% female, mean age 52.8 years).
  • Middle cerebral artery aneurysms were most common.
  • Isolated aSDH patients had better recovery (38%) than those with aSAH (6%).
  • aSAH presence increased odds of unfavorable outcome (OR 2.68).
  • Surgical treatment showed inverse association with unfavorable outcomes in univariable analysis.

Conclusions:

  • aSDH is infrequent, but its simultaneous occurrence with aSAH leads to poor outcomes.
  • Surgical treatment is linked to reduced rates of unfavorable outcomes, including death and severe disability.