Document Type

Article

Original Publication Date

2017

Journal/Book/Conference Title

NEUROSURGERY CLINICS OF NORTH AMERICA

Volume

28

Issue

2

First Page

247

Last Page

255

DOI of Original Publication

10.1016/j.nec.2016.11.007

Comments

Originally published at https://doi.org/10.1016/j.nec.2016.11.007

Date of Submission

June 2017

Abstract

  • Although guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are widely available, the evidence supporting these guidelines is weak, and management of these patients must often be individualized.
  • Smaller ASDHs in patients in good neurologic condition usually can be successfully managed without surgery.
  • Large ASDHs with minimal mass effect in patients with minimal symptoms also may be considered for nonoperative management.
  • The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas, but it is reasonable to reverse the effects of these medications promptly.
  • Close clinical and radiologic follow-up is needed in these patients, both acutely to detect rapid expansion of an ASDH, and subacutely to detect formation of a large subacute or chronic subdural hematoma.

Rights

Copyright © 2016 Elsevier Inc. All rights reserved.

Is Part Of

VCU Neurosurgery Publications

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