Non-surgical management of chronic subdural hematoma: insights and future perspectives from an international survey including neurosurgeons from 90 countries worldwide.
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| Title: | Non-surgical management of chronic subdural hematoma: insights and future perspectives from an international survey including neurosurgeons from 90 countries worldwide. |
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| Authors: | De Maria, Lucio (AUTHOR), Chaurasia, Bipin (AUTHOR), Agosti, Edoardo (AUTHOR), Garg, Kanwaljeet (AUTHOR), Burkhardt, Jan-Karl (AUTHOR), Goehre, Felix (AUTHOR), Borghei-Razavi, Hamid (AUTHOR), Servadei, Franco (AUTHOR), Fontanella, Marco Maria (AUTHOR) |
| Source: | International Journal of Neuroscience. Jan2025, Vol. 135 Issue 1, p70-79. 10p. |
| Subjects: | Subdural hematoma, Endovascular surgery, Patient selection, Platelet aggregation inhibitors, Middle managers |
| Abstract: | Background: Chronic subdural hematoma (cSDH) is one of the most common neurosurgical conditions. Although surgical evacuation is still the gold standard for treatment, recent advances have led to the development of other management strategies, such as medical therapies and endovascular middle meningeal artery (MMA) embolization. Through this international survey, we investigated the global trends in cSDH management, focusing on medical and endovascular treatments. Design and participants: A 14-question, web-based, anonymous survey was distributed to neurosurgeons worldwide. Results: Most responders do not perform MMA embolization (69.5%) unless for specific indications (29.6%). These indications include residual cSDH after surgical evacuation (58.9%) or cSDH in patients on antiplatelet medications to avoid surgical evacuation (44.8%). Survey participants from teaching versus non-teaching hospitals (p = 0.002), public versus private hospitals (p = 0.022), and Europe versus other continents (p < 0.001) are the most users of MMA embolization. A large number of participants (51%) declare they use a conservative/medical approach, mainly to avoid surgery in patients with small cSDH (74.8%). Conclusions: This survey highlights the current trends of cSDH management, focusing on conservative and MMA embolization treatment strategies. Most responders prefer a conservative approach for patients with small cSDHs not requiring surgical evacuation. However, in higher-risk scenarios such as residual hematomas after surgery or patients on antiplatelet medications, MMA embolization is regarded as a reasonable option by participants. Future studies should clarify the indications of MMA embolization, including appropriate patient selection and efficacy as a stand-alone procedure. [ABSTRACT FROM AUTHOR] |
| Copyright of International Journal of Neuroscience is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 182091270 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Non-surgical management of chronic subdural hematoma: insights and future perspectives from an international survey including neurosurgeons from 90 countries worldwide. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22De+Maria%2C+Lucio%22">De Maria, Lucio</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chaurasia%2C+Bipin%22">Chaurasia, Bipin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Agosti%2C+Edoardo%22">Agosti, Edoardo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Garg%2C+Kanwaljeet%22">Garg, Kanwaljeet</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burkhardt%2C+Jan-Karl%22">Burkhardt, Jan-Karl</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Goehre%2C+Felix%22">Goehre, Felix</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Borghei-Razavi%2C+Hamid%22">Borghei-Razavi, Hamid</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Servadei%2C+Franco%22">Servadei, Franco</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fontanella%2C+Marco+Maria%22">Fontanella, Marco Maria</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Neuroscience%22">International Journal of Neuroscience</searchLink>. Jan2025, Vol. 135 Issue 1, p70-79. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Subdural+hematoma%22">Subdural hematoma</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+selection%22">Patient selection</searchLink><br /><searchLink fieldCode="DE" term="%22Platelet+aggregation+inhibitors%22">Platelet aggregation inhibitors</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+managers%22">Middle managers</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Chronic subdural hematoma (cSDH) is one of the most common neurosurgical conditions. Although surgical evacuation is still the gold standard for treatment, recent advances have led to the development of other management strategies, such as medical therapies and endovascular middle meningeal artery (MMA) embolization. Through this international survey, we investigated the global trends in cSDH management, focusing on medical and endovascular treatments. Design and participants: A 14-question, web-based, anonymous survey was distributed to neurosurgeons worldwide. Results: Most responders do not perform MMA embolization (69.5%) unless for specific indications (29.6%). These indications include residual cSDH after surgical evacuation (58.9%) or cSDH in patients on antiplatelet medications to avoid surgical evacuation (44.8%). Survey participants from teaching versus non-teaching hospitals (p = 0.002), public versus private hospitals (p = 0.022), and Europe versus other continents (p < 0.001) are the most users of MMA embolization. A large number of participants (51%) declare they use a conservative/medical approach, mainly to avoid surgery in patients with small cSDH (74.8%). Conclusions: This survey highlights the current trends of cSDH management, focusing on conservative and MMA embolization treatment strategies. Most responders prefer a conservative approach for patients with small cSDHs not requiring surgical evacuation. However, in higher-risk scenarios such as residual hematomas after surgery or patients on antiplatelet medications, MMA embolization is regarded as a reasonable option by participants. Future studies should clarify the indications of MMA embolization, including appropriate patient selection and efficacy as a stand-alone procedure. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of International Journal of Neuroscience is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/00207454.2023.2286202 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 70 Subjects: – SubjectFull: Subdural hematoma Type: general – SubjectFull: Endovascular surgery Type: general – SubjectFull: Patient selection Type: general – SubjectFull: Platelet aggregation inhibitors Type: general – SubjectFull: Middle managers Type: general Titles: – TitleFull: Non-surgical management of chronic subdural hematoma: insights and future perspectives from an international survey including neurosurgeons from 90 countries worldwide. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: De Maria, Lucio – PersonEntity: Name: NameFull: Chaurasia, Bipin – PersonEntity: Name: NameFull: Agosti, Edoardo – PersonEntity: Name: NameFull: Garg, Kanwaljeet – PersonEntity: Name: NameFull: Burkhardt, Jan-Karl – PersonEntity: Name: NameFull: Goehre, Felix – PersonEntity: Name: NameFull: Borghei-Razavi, Hamid – PersonEntity: Name: NameFull: Servadei, Franco – PersonEntity: Name: NameFull: Fontanella, Marco Maria IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: Jan2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 00207454 Numbering: – Type: volume Value: 135 – Type: issue Value: 1 Titles: – TitleFull: International Journal of Neuroscience Type: main |
| ResultId | 1 |
