Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Effect of Antithrombotic Therapy on Development of Acute Subdural Hematoma After Burr Hole Drainage of Chronic Subdural Hematoma(2020) Yuksel, Mehmet Onur; Cevik, Serdar; Erdogan, Baris; Tunckale, Tamer; Katar, Salim; Isik, Semra; Caliskan, Tezcan; Evran, Sevket; 32996579AIM: To evaluate the relationship between the time from cessation of anticoagulant/antiplatelet medication to surgery and risk of postoperative acute subdural hematoma (ASDH) after burr hole drainage of chronic subdural hematoma (CSDH). MATERIAL and METHODS: A retrospective study of patients who underwent burr hole drainage of CSDH between December 2014 and December 2019 was performed. Demographic and clinical data regarding age, gender, medication (antithrombotic therapy), smoking, daily alcohol consumption, history of head trauma, presenting symptoms, and neurological examination were collected from the medical records. Patients were divided into 3 groups based on time from referral to surgery: <24 hours, 24-72 hours, and >72 hours. RESULTS: One hundred seventeen patients underwent burr hole drainage of CSDH during the 5-year study period. Seventy-two patients were male (61.5%) and 45 were female (38.5%). Mean age was 70.5 +/- 7.2 years. Postoperative ASDH occurred in 2 of the 32 patients (6.3%) who were not taking antithrombotic medication and 6 of the 85 patients (7.1%) who were taking antithrombotic medication. The difference was not significant (p=0.797). CONCLUSION: The risk of ASDH after burr hole drainage of CSDH was not affected by antithrombotic medication. Although the literature suggests that antiplatelet and anticoagulant drugs to be discontinued between 5 and 7 days before surgery, our results showed that acute hemorrhage was not detected in any patient who underwent surgery more than 72 hours after referral.Item Chronic Subdural Hematoma Associated with Arachnoid Cyst of the Middle Fossa: Surgical Treatment and Mid-Term Results in Fifteen Patients(2018) Kircelli, Atilla; Musluman, Ahmet Murat; Ozsoner, Baris; Can, Songul Meltem; Yilmaz, Adem; Kaldirimoglu, Ayca; Sahin, Balkan; 0000-0003-2109-1274; 29131236AIM: To report neurological and radiological features, surgical management, and mid-term outcomes of patients with chronic subdural hematoma (CSDH) associated with ipsilateral arachnoid cyst (AC) of the middle fossa. MATERIAL and METHODS: A total of 453 patients with CSDH were treated at our clinic between August 2004 and August 2012. Of these patients, 15 had ipsilateral AC in the middle fossa. A single burr hole craniostomy was performed to drain the hematoma. The AC was left intact in 14 patients, and one patient had no surgical intervention. The follow-up period ranged from 13 to 88 months (mean 43.07 +/- 23.23 months). RESULTS: The patients with AC associated CSDH were found to be younger than the patients with CSDH alone, and the mean age of 58 patients was 13.15 +/- 13.17 years, while it was 11 +/- 14.22 years in the other patients. Eleven patients had experienced head trauma at 21-50 days before admission. Hematoma evacuation through a single burr hole with closed-system subdural drainage performed at 2-4 days after surgery improved the symptoms in all patients. Two patients developed subdural fluid collection, which was treated by subduroperitoneal shunt placement. CONCLUSION: Greater prevalence of ACs in patients with CSDHs has been reported in the literature. We recommend the drainage of the hematoma via a single craniostomy and to leave the AC intact as the first choice of treatment if the associated AC is a Galassi type I or II. Additional subduroperitoneal shunting may be performed in patients with Galassi type III cyst.