Introduction
Methods
Statistical analysis
Results
Patient demographics
Number | 29 |
Age, median [IQR], years | 79 [70–86.1] |
Sex (female) | 13 (44.8%) |
Medical history | |
Hypertonus | 20 (44.8%) |
Diabetes mellitus type 2 | 10 (34.5%) |
Atrial fibrillation | 6 (20.7%) |
Cardiovascular disease | 7 (24.1%) |
Coronary disease | 10 (34.5%) |
Respiratory disease | 2 (6.9%) |
Renal disease | 9 (31.0%) |
Metabolic disease | 9 (31.0%) |
Remote stroke/TIA | 6 (20.7%) |
Hematologic disease | 5 (17.2%) |
Oncology | 4 (13.8%) |
Drug history | |
Anticoagulation | 7 (24.1%) |
-Marcumar | 4 (13.8%) |
-DOACs | 3 (10.3%) |
Antiplatelet | 10 (34.5%) |
GCS at admission | |
GCS 13–15 | 22 (75.9%) |
GCS 9–12 | 5 (17.2%) |
GCS 3–8 | 2 (6.9%) |
Symptoms at admission | |
Impaired consiousness | 5 (17.2%) |
Vomiting | 2 (6.9%) |
Paresis | 11 (37.9%) |
Gait impairment | 15 (51.7%) |
Speech arrest | 5 (17.2%) |
Syncope | 1 (3.4%) |
Seizure | 3 (10.3%) |
Other symptoms | 4 (13.8%) |
CT | |
Volume, median [IQR], cm3 | 146.3 [115.5–164.3] |
Midline shift, median [IQR], mm | 6.5 [3.4–10.7] |
Side | |
Left | 10 (34.5%) |
Right | 8 (27.6%) |
Both | 11 (37.9%) |
Seizure and status epilepticus
Case no. | Age (years), Sex | Diagnosis | Surgery | Complication | 2. Surgery | Seizure | Pre-surgery | After 1. Surgery | After 2. Surgery | Status Epilepticus | Antiepilieptic treatment | mRS (discharge) | GOS (discharge) | mRS (follow-up) | GOS (follow-up) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 44, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Valproat,Carbamazepin | 0 | 5 | 0 | 5 |
2 | 72, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracteam, Lacosamid, Valproat,Topiramat | 2 | 4 | 1 | 5 |
3 | 78, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | 3 | 3 | 1 | 5 |
4 | 79, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | 3 | 3 | 3 | 3 |
5 | 71, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | Yes | No | No | No | No | 3 | 4 | 2 | 4 |
6 | 86, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | Yes | No | No | No | Levetiracetam | 4 | 3 | 3 | 3 |
7 | 57, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | 3 | 3 | 2 | 3 |
8 | 82,W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | 4 | 3 | 4 | 3 |
9 | 50, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | 3 | 3 | 2 | 4 |
10 | 70, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | Yes | No | No | Levetiracetam,Valproat | 4 | 3 | 3 | 3 |
11 | 96, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracetam | 6 | 1 | 6 | 1 |
12 | 81. M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | Yes | Yes | Yes | No | Levetiracetam | 5 | 2 | NA | NA |
13 | 70,W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | Yes | Levetiracetam, Lacosamid | 5 | 2 | 5 | 2 |
14 | 91, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracetam | 6 | 1 | 6 | 1 |
15 | 88, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | Yes | Levetiracetam, Lacosamid | 3 | 3 | 3 | 3 |
16 | 80, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracetam | 2 | 4 | 2 | 5 |
17 | 75, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | Yes | Yes | No | Levetiracetam,Lacosamid | 4 | 3 | 5 | 3 |
18 | 90, M | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | No | No | 3 | 3 | NA | NA |
19 | 88, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracetam | 6 | 1 | 6 | 1 |
20 | 91, W | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracetam, Lacosamid | 6 | 1 | 6 | 1 |
21 | 82, M | Acute-on-cSDH | Craniotomy | No | No | Yes | No | No | Yes | Yes | Levetiracetam | 3 | 3 | 3 | 3 |
22 | 58, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | 1 | 5 | 0 | 5 |
23 | 80, M | cSDH | Burrhole | Acute-on-cSDH | Craniotomy | Yes | No | No | Yes | No | Levetiracetam | 5 | 2 | 5 | 2 |
24 | 76, W | Acute-on-cSDH | Craniotomy | No | No | Yes | No | No | Yes | No | Levetiracetam | 6 | 1 | 6 | 1 |
25 | 65, M | Acute-on-cSDH | Burrhole | No | No | Yes | No | No | Yes | No | Levetiracetam | 1 | 5 | 1 | 5 |
26 | 80, M | Acute-on-cSDH | Craniotomy | No | No | Yes | No | No | Yes | No | Levetiracetam | 2 | 4 | NA | NA |
27 | 72, W | cSDH | Burrhole | Acute-on-cSDH | Craniectomy | Yes | No | No | Yes | No | Levetiracetam | 2 | 4 | 2 | 4 |
28 | 91, W | cSDH | Burrhole | Acute-on-cSDH | Craniectomy | Yes | No | No | Yes | No | Levetiracetam | 6 | 1 | 6 | 1 |
29 | 69, W | Acute-on-cSDH | Craniotomy | No | No | No | No | No | No | No | No | 5 | 2 | 6 | 1 |
Surgical outcomes at discharge and follow-up
Unfavorable outcome | Favorable outcome | p value | |
---|---|---|---|
Number | 14 | 15 | |
Age > 80 years | 8 (57.1%) | 3 (20%) | 0.04 |
Medical history | |||
Hypertension | 11 (78.6%) | 9 (60%) | 0.28 |
Diabetes mellitus | 5 (35.7%) | 5 (33.3%) | 0.89 |
Atrial fibrillation | 3 (21.4%) | 3 (20%) | 0.92 |
Cardiovascular disease | 5 (35.7%) | 2 (13.3%) | 0.16 |
Coronary disease | 4 (28.6%) | 6 (40%) | 0.52 |
Respiratory disease | 2 (14.3%) | 0 (0%) | 0.13 |
Renal disease | 6 (42.9%) | 3 (20%) | 0.18 |
Metabolic disease | 4 (28.6%) | 5 (33.3%) | 0.78 |
Remote stroke/TIA | 4 (28.6%) | 2 (13.3%) | 0.31 |
Hematologic disease | 3 (21.4%) | 2 (13.3%) | 0.56 |
Oncology | 3 (21.4%) | 1 (6.7%) | 0.25 |
Comorbidites, median [IQR] | 4 [2.8–5.3] | 3 [2–4.5] | 0.17* |
Anticoagulation/antiplatelet | 9 (64.3%) | 8 (53.3%) | 0.55 |
GCS at admission | |||
3–8 | 2 (14.3%) | 0 (0%) | 0.13 |
9–12 | 3 (21.4%) | 2 (13.3%) | 0.56 |
13–15 | 9 (64.3%) | 13 (86.7%) | 0.16 |
Radiological parameter | |||
Unilateral | 7 (50%) | 11 (73.3%) | 0.20 |
Midline shift, median [IQR] | 6.5 [2.6–10.2] | 6.5 [3.1–10.35] | 0.53* |
Volume, median [IQR] | 146.2 [117.0–162.6] | 148.6 [124.7–164.5] | 0.75* |
Infection | 7 (50%) | 4 (26.7%) | 0.20 |
Pneumonia | 4 (28.6%) | 3 (20%) | 0.59 |
Urinary tract | 3 (21.4%) | 1 (6.7%) | 0.25 |
Seizure | 12 (85.7%) | 9 (60%) | 0.12 |
Status epilepticus | 1 (7.1%) | 2 (13.3%) | 0.58 |
Unfavorable outcome | Favorable outcome | p value | |
---|---|---|---|
Number | 11 | 15 | |
Age > 80 years | 6 (54.5%) | 3 (20%) | 0.07 |
Medical history | |||
Hypertension | 9 (81.8%) | 9 (60%) | 0.23 |
Diabetes mellitus | 5 (45.5%) | 4 (26.7%) | 0.87 |
Atrial fibrillation | 3 (27.3%) | 2 (13.3%) | 0.37 |
Cardiovascular disease | 4 (36.4%) | 1 (6.7%) | 0.06 |
Coronary disease | 4 (36.4%) | 4 (26.7%) | 0.6 |
Respiratory disease | 2 (18.2%) | 0 (0%) | 0.09 |
Renal disease | 4 (36.4%) | 3 (20%) | 0.35 |
Metabolic disease | 3 (27.3%) | 3 (20%) | 0.66 |
Remote stroke/TIA | 2 (18.2%) | 3 (20%) | 0.91 |
Hematologic disease | 3 (27.3%) | 2 (13.3%) | 0.37 |
Oncology | 3 (27.3%) | 1 (6.7%) | 0.15 |
Comorbidities, median [IQR] | 4 [2.3–5.8] | 3 [2–4.5] | 0.04* |
Anticoagulation/antiplatelet | 7 (63.6%) | 7 (46.7%) | 0.39 |
GCS at admission | |||
3–8 | 1 (9%) | 0 (0%) | 0.23 |
9–12 | 3 (27.3%) | 1 (6.7%) | 0.15 |
13–15 | 7 (63.6%) | 14 (93.3%) | 0.06 |
Radiological parameter | |||
Unilateral | 6 (54.5%) | 10 (66.7%) | 0.53 |
Midline shift, median [IQR] | 0.68* | ||
Volume, median [IQR] | 0.8* | ||
Infection | 7 (63.6%) | 2 (13.3%) | 0.01 |
Pneumonia | 4 (36.4%) | 2 (13.3%) | 0.17 |
Urinary tract | 3 (27.3%) | 0 (0%) | 0.03 |
Seizure | 9 (81.8%) | 10 (66.7%) | 0.39 |
Status epilepticus | 1 (9%) | 2 (13.3%) | 0.74 |