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Für einige Tage nach der OP empfiehlt sich die Einlage einer Drainage. Eine weitere Behandlungsmöglichkeit besteht in der Embolisation der Arteria meningea media.
It is crucial to strike a balance between the risks of haematoma recurrence and the need for reoperation with a shorter duration of drainage, and drain-related complications, patient immobilisation, and health-care costs associated with longer hospital stays from prolonged drainage periods.
Conclusion: Simple burr hole drainage is as effective as burr hole drainage with irrigation according to up to date knowledge. The technique without irrigation, as less invasive and faster, seems to be better for the treatment of chronic subdural haematoma.
Subdural hemorrhages are believed to be due to stretching and tearing of bridging cortical veins as they cross the subdural space to drain into an adjacent dural sinus. These veins rupture due to shearing forces when there is a sudden change in the velocity of the head.
Subdural hematomas may cause an increase in the pressure inside the skull, which in turn can cause compression of and damage to delicate brain tissue. Acute subdural hematomas are often life-threatening. Chronic subdural hematomas have a better prognosis if properly managed.
This review provides a comprehensive overview of the contemporary management strategies for acute and chronic subdural hematomas, delineating their distinct clinical characteristics, risk factors, etiologies, and treatment paradigms.
Hintergrund: Das chronische subdurale Hämatom (cSDH) ist eine typische Erkrankung älterer Patientinnen und Patienten. Bei Hämatomen über Kalottenbreite ist meist die operative Therapie...
Drainage, Entlastung, akutes subdurales Hämatom durch Verletzung von cortikalen Venen, Brückenvenen, Sinus mit Hirnsubstanzschädigung.
Surgery should include the placement of a temporary drain, either subdural or subgaleal where safe to do so. Burr hole drainage with the use of a drain should be considered as first-line surgical management.
Da hier ein langsam progredienter Verlauf und nur unspezifische Symptome vorliegen (dazu meist bei älteren Patienten), kann ein chronisches subdurales Hämatom leicht übersehen werden!