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intracranial_acute_traumatic_subdural_hematoma [2019/09/19 12:27]
administrador [Case reports]
intracranial_acute_traumatic_subdural_hematoma [2021/08/03 22:14] (current)
administrador [Diagnosis]
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 Acute laminar traumatic subdural hematoma Acute laminar traumatic subdural hematoma
 +===== Biomarkers =====
 +[[Brain natriuretic peptide]] (BNP) is a reliable [[biomarker]] in the acute phase of [[traumatic brain injury]]. However, the relationship between BNP and traumatic [[acute subdural hematoma]] (aSDH) has not yet been addressed. A study aimed to analyze BNP levels on admission in surgically treated patients and assess their relationship with early [[postoperative seizure]]s (EPS) and [[functional outcome]]s.
 +Patients with unilateral traumatic aSDH who were surgically treated between July 2017 and May 2020 were included in the study. BNP was preoperatively measured. Patients' neurologic condition, radiographic variables on initial cranial computed tomography, sodium serum levels on admission, and occurrence of EPS were prospectively assessed. Functional outcome was assessed using the modified Rankin Scale (mRS) at discharge and follow-up (at 2-3 months). A poor outcome was defined by a mRS score > 3.
 +EPS occurred in 20 (19.6%) of 102 surgically treated patients in the final cohort on the median day 3. A significant association between EPS and a poor Glasgow Coma Scale score at the 7th postoperative day was found, which in turn independently predicted a poor functional outcome at discharge and follow-up. Nonetheless, EPS were not associated with poor functional outcomes. The multivariate analysis revealed BNP > 95.4 pg/ml (aOR = 5.7, p = 0.003), sodium < 137.5 mmol/l (aOR = 4.6, p = 0.009), and left-sided aSDH (aOR = 4.4, p = 0.020) as independent predictors of EPS.
 +In the early postoperative phase of traumatic aSDH, EPS was associated with worse neurologic conditions, which in turn independently predicted poor outcomes at discharge and follow-up. Although several EPS risk factors have already been elucidated, this study presents BNP as a novel reliable predictor of EPS. Further larger studies are needed to determine whether a more precise estimate of EPS risk using BNP levels can be reached
 +((Chihi M, Darkwah Oppong M, Quesada CM, Dinger TF, Gembruch O, Pierscianek D, Ahmadipour Y, Uerschels AK, Wrede KH, Sure U, Jabbarli R. Role of Brain Natriuretic Peptide in the Prediction of Early Postoperative Seizures Following Surgery for Traumatic Acute Subdural Hematoma: A Prospective Study. Neurol Ther. 2021 Aug 3. doi: 10.1007/s40120-021-00269-w. Epub ahead of print. PMID: 34342872.)).
 ===== Treatment ===== ===== Treatment =====
  • intracranial_acute_traumatic_subdural_hematoma.txt
  • Last modified: 2021/08/03 22:14
  • by administrador