Pathophysiology and Nonsurgical Treatment of Chronic Subdural Hematoma: From Past to Present to Future

World Neurosurgery
Dana C HollDutch Chronic Subdural Hematoma Research Group (DSHR)

Abstract

Chronic subdural hematoma (CSDH) is one of the more frequent pathologic entities in daily neurosurgical practice. Historically, CSDH was considered progressive recurrent bleeding with a traumatic cause. However, recent evidence has suggested a complex intertwined pathway of inflammation, angiogenesis, local coagulopathy, recurrent microbleeds, and exudates. The aim of the present review is to collect existing data on pathophysiology of CSDH to direct further research questions aiming to optimize treatment for the individual patient. We performed a thorough literature search in PubMed, Ovid, EMBASE, CINAHL, and Google scholar, focusing on any aspect of the pathophysiology and nonsurgical treatment of CSDH. After a (minor) traumatic event, the dural border cell layer tears, which leads to the extravasation of cerebrospinal fluid and blood in the subdural space. A cascade of inflammation, impaired coagulation, fibrinolysis, and angiogenesis is set in motion. The most commonly used treatment is surgical drainage. However, because of the pathophysiologic mechanisms, the mortality and high morbidity associated with surgical drainage, drug therapy (dexamethasone, atorvastatin, tranexamic acid, or angiotensin-converting enzyme inhibito...Continue Reading

Associated Clinical Trials

References

May 1, 1991·The Anatomical Record·D E Haines
Sep 1, 1988·Surgical Neurology·H ItoT Hasegawa
Jan 1, 1985·Acta Neuropathologica·T Yamashima, S Yamamoto
Jan 1, 1972·The Medical Clinics of North America·H C Kwaan
Aug 1, 1974·Archives of Neurology·M B Bender, N Christoff
Jan 1, 1984·Clinical Neuropharmacology·G ConcolinoC Conti
Jan 1, 1993·Neurosurgery·D E HainesO al-Mefty
Feb 1, 1996·British Journal of Neurosurgery·T van HavenberghC Plets
Apr 2, 1998·Acta neurochirurgica·M SuzukiA Ogawa
Apr 29, 1998·Nature·M Baggiolini
Sep 2, 1999·The New England Journal of Medicine·A J Singer, R A Clark
Nov 9, 2000·Journal of Korean Medical Science·K S LeeI G Yun
Jan 25, 2002·Postgraduate Medical Journal·V AdhiyamanB K Bhowmick
Feb 13, 2003·Acta Neurologica Scandinavica·S A KönigH-E Vitzthum
Mar 18, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·J Sajanti, K Majamaa
Jan 27, 2004·Brain Injury : [BI]·K-S Lee
Feb 6, 2004·Arquivos de neuro-psiquiatria·Clarissa Lin YasudaHélvio Leite Alves
Apr 13, 2005·Clinical Neurology and Neurosurgery·Miguel Gelabert-GonzálezRamón Martínez-Rumbo
Feb 10, 2006·The New England Journal of Medicine·Israel F Charo, Richard M Ransohoff
Dec 20, 2008·Journal of Korean Neurosurgical Society·Byung-Soo KoSoo-Han Kim
Aug 19, 2009·Neurocirugía·P D Delgado-LópezO Fernández-Arconada
Oct 9, 2009·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·F A AraújoS P Andrade
Feb 23, 2010·International Journal of Surgery·David MoherUNKNOWN PRISMA Group
Feb 12, 2011·Journal of Neurotrauma·Mikiko FunaiMasakazu Takayasu
Oct 19, 2011·Annals of Internal Medicine·Penny F WhitingUNKNOWN QUADAS-2 Group
Apr 25, 2012·Inflammation Research : Official Journal of the European Histamine Research Society ... [et Al.]·Milo StanisicTerje Sæhle
May 31, 2012·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·L M E Berghauser PontR Dammers
Nov 24, 2012·Neuroscience Letters·Koji OsukaMasakazu Takayasu
Nov 28, 2012·Neurologia Medico-chirurgica·Masatoshi KitazonoAkira Teramoto
May 2, 2013·Neurosurgery·Anna-Leena HeulaKari Majamaa
Sep 18, 2013·Journal of Korean Neurosurgical Society·Hye-Ran ParkJae-Won Doh

❮ Previous
Next ❯

Citations

Feb 7, 2020·Acta neurochirurgica·E EdlmannUNKNOWN International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group
Oct 22, 2018·Trials·Ishita P MiahUNKNOWN Dutch Subdural Hematoma Research Group (DSHR)
Dec 12, 2019·Frontiers in Pharmacology·Bei LiuYan Qu
Feb 5, 2021·Medicina·Mariarosaria AromatarioBenedetta Baldari
Apr 1, 2021·Journal of Neurotrauma·Roger LodewijkxDagmar Verbaan
Apr 1, 2021·Journal of Neurotrauma·Ellie EdlmannPeter J Hutchinson
Jul 2, 2021·Journal of Neurointerventional Surgery·Natasha IronsideDale Ding
Jun 12, 2018·World Neurosurgery·James R van Dellen
Mar 30, 2019·World Neurosurgery·Matheus Fernandes de Oliveira

❮ Previous
Next ❯

Related Concepts

Related Feeds

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.