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The Neurocritical and Neurosurgical Care of Subdural Hematomas.

Publication ,  Journal Article
Huang, KT; Bi, WL; Abd-El-Barr, M; Yan, SC; Tafel, IJ; Dunn, IF; Gormley, WB
Published in: Neurocrit Care
April 2016

Subdural hematomas (SDHs), though frequently grouped together, can result from a variety of different etiologies, and therefore many different subtypes exist. Moreover, the high incidence of these lesions in the neurocritical care settings behooves practitioners to have a firm grasp on their diagnosis and management. We present here a review of SDHs, with an emphasis on how different subtypes of SDHs differ from one another and with discussion of their medical and surgical management in the neurocritical care setting. In this paper, we discuss considerations for acute, subacute, and chronic SDHs and how presentation and management may change in both the elderly and pediatric populations. We discuss SDHs that arise in the setting of anticoagulation, those that arise in the setting of active cerebrospinal fluid diversion, and those that are recurrent and recalcitrant to initial surgical evacuation. Management steps reviewed include detailed discussion of initial assessment, anticoagulation reversal, seizure prophylaxis, blood pressure management, and indications for intracranial pressure monitoring. Direct surgical management options are reviewed, including open craniotomy, twist-drill, and burr-hole drainage and the usage of subdural drainage systems. SDHs are a common finding in the neurocritical care setting and have a diverse set of presentations. With a better understanding of the fundamental differences between subtypes of SDHs, critical care practitioners can better tailor their management of both the patient's intracranial and multi-systemic pathologies.

Duke Scholars

Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

April 2016

Volume

24

Issue

2

Start / End Page

294 / 307

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • Humans
  • Hematoma, Subdural, Chronic
  • Hematoma, Subdural, Acute
  • 4205 Nursing
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Huang, K. T., Bi, W. L., Abd-El-Barr, M., Yan, S. C., Tafel, I. J., Dunn, I. F., & Gormley, W. B. (2016). The Neurocritical and Neurosurgical Care of Subdural Hematomas. Neurocrit Care, 24(2), 294–307. https://doi.org/10.1007/s12028-015-0194-x
Huang, Kevin T., Wenya Linda Bi, Muhammad Abd-El-Barr, Sandra C. Yan, Ian J. Tafel, Ian F. Dunn, and William B. Gormley. “The Neurocritical and Neurosurgical Care of Subdural Hematomas.Neurocrit Care 24, no. 2 (April 2016): 294–307. https://doi.org/10.1007/s12028-015-0194-x.
Huang KT, Bi WL, Abd-El-Barr M, Yan SC, Tafel IJ, Dunn IF, et al. The Neurocritical and Neurosurgical Care of Subdural Hematomas. Neurocrit Care. 2016 Apr;24(2):294–307.
Huang, Kevin T., et al. “The Neurocritical and Neurosurgical Care of Subdural Hematomas.Neurocrit Care, vol. 24, no. 2, Apr. 2016, pp. 294–307. Pubmed, doi:10.1007/s12028-015-0194-x.
Huang KT, Bi WL, Abd-El-Barr M, Yan SC, Tafel IJ, Dunn IF, Gormley WB. The Neurocritical and Neurosurgical Care of Subdural Hematomas. Neurocrit Care. 2016 Apr;24(2):294–307.
Journal cover image

Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

April 2016

Volume

24

Issue

2

Start / End Page

294 / 307

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • Humans
  • Hematoma, Subdural, Chronic
  • Hematoma, Subdural, Acute
  • 4205 Nursing
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences