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KMID : 1150320160120020232
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Journal of Korean Society of Geriatric Neurosurgery
2016 Volume.12 No. 2 p.232 ~ p.236
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Relationship Between Chronic Subdural Hematoma and the Development or Progression of Brain Atrophy
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Oh Han-San
Kim Tae-Wan
Oh Hyung-Sug
Park Kwan-Ho
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Abstract
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Objective: Brain atrophy may occur with aging, or traumatic brain injury, or because of diseases such as multiple sclerosis, Alzheimer’s disease, dementia, or infection. Brain atrophy can induce cognitive decline and lead to memory impairment. The purpose of this study was to evaluate the relationship between chronic subdural hematoma (CSDH) and the development or progression of brain atrophy after surgery.
Methods: A retrospective study was performed on 33 patients with CSDH from January 2010 to December 2012. All patients had undergone surgery with burr hole trephination, hematoma drainage, and pre- and post-operative radiologic brain evaluation, with at least 12-month follow-up. We excluded patients who did not have a pre-operative brain evaluation with which to compare postoperative changes. We measured brain atrophy using the Pasquier cortical atrophy scale. We divided the patients into two groups: the brain atrophy group (n=9) and non-atrophy group (n=24).
Results: The mean age and follow-up period of patients were 76.7 years and 23.9 months, respectively. Development or progression of brain atrophy occurred in nine patients (27.3%). Development or progression of brain atrophy occurred more commonly in cases that the patients was older than 75 years, presented with CSDH with a history of trauma, or presented recurrence of CSDH; however, the differences were not statistically significant.
Conclusion: We suggest that CSDH may possibly induce or exacerbate brain atrophy. Greater caution and longer follow-up may be needed after CSDH surgery in cases with an elderly patient, history of trauma prior to CSDH, and recurrence of CSDH.
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KEYWORD
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Subdural hematoma, Brain atrophy, Elderly, Trauma, Recurrence
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