Journal Information
Vol. 12. Issue 4.
Pages 325-330 (January 2001)
Share
Share
Download PDF
More article options
Vol. 12. Issue 4.
Pages 325-330 (January 2001)
Hematoma subdural crónico en el paciente mayor de 80 años
Chronic subdural hematoma in elderly patients over 80
Visits
3079
M. Gelabert-González
, J.M. Fernández-Villa, E. López-García, A. García-Allut
Servicio de Neurocirugía. Hospital Clínico de Santiago. Departamento de Cirugía. Universidad de Santiago de Compostela
This item has received
Article information
Resumen
Introducción

el hematoma subdural crónico constituye el tipo más frecuente de hemorragia intracraneal postraumática. La mayoría, de los casos se desarrollan en pacientes de edad avanzada, presentando problemas específicos derivados de las patologías frecuentes en este grupo de edad.

Pacientes y métodos

realizamos un estudio retrospectivo sobre 90 pacientes mayores de 80 años afectos de hematoma subdural crónico intervenidos en los últimos 15 años. Para la evaluación clínica al ingreso y alta hospitalaria empleamos la escala específica propuesta por Markwalder. La técnica quirúrgica empleada fue similar en todos los casos y consistente en la realización de un agujero de trépano e implantación de un drenaje subdural cerrado.

Resultados

al ingreso, 73 pacientes (80%) se encontraban en buena situación clínica (grados 0–2) y 17 (20%) en grados 3 ó 4. Siete pacientes (7.7%) fallecieron durante el ingreso pero ninguno de ellos en relación directa con la cirugía. Seis pacientes (6.6%) requirieron una segunda intervención quirúrgica por recidiva del hematoma. Al alta el 76.6% de los pacientes se encontraban en grados 0 ó 1.

Conclusiones

en nuestra experiencia el hematoma subdural crónico en este grupo de edad debe ser tratado como primera opción mediante una perforación craneal y drenaje subdural. Dado los buenos resultados obtenidos la existencia de patología sistémica asociada no debe considerarse como una contraindicación para el tratamiento quirúrgico.

Palabras clave:
Agujero de trépano
Anciano
Drenaje subdural
Hematoma subdural crónico
Summary
Introducion

Chronic subdural hematoma (CSH) rrepresents one of the most frequent types of intracranial hemorrhage. Most occur in elderly patients causing a variety of therapeutic problems associated to systemic diseases.

Patients and methods

A retrospective study of 90 patients older than 80 years of age with chronic subdural hematoma treated in the last 15 years was undertaken. For clinical evaluation on admission and at discharge we used the classification of Markwalder. Surgical treat-ment was performed in all patients and a burr hole craniostomy with closed drainage system was used.

Results

on admission, 73 patients (80%) were in satisfactory condition (grades 0-2); 17 (20%) were grade 3 or 4. Seven (7.7%) patients died but none due to surgery. In 6 (6.6%) of the patients, surgical reintervention was required to remove a recurring CSH. In 76.6% of the patients, the results achieved were graded 0 or 1.

Conclusions

In our experience CSH in elderly patients should be treated with minimal surgery with a simple drainage of the subdural space. The good results suggest that the procedure could be considered as a first procedure in these patients and that age or concomitant diseases do not appear to be poor prognostic factors.

Key words:
Burr hole
Chronic subdural hematoma
Elderly
Subdural drainage

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Neurocirugía (English edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?