Mixed-density extradural hematomas on computed tomography—prognostic significance
Abstract Background It has been variably reported that patients who acutely present with low- or mixed-density blood on CT scan are associated with poor clinical outcome. The aim of the study was to correlate the presence or absence of mixed density within EDHs on CT scanning with the clinical outco...
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| Veröffentlicht in: | Surgical neurology 2009-02, Vol.71 (2), p.202-206 |
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| creator | Pruthi, Nupur, MCh Balasubramaniam, Anandh, MS, MCh Chandramouli, Bangalore A., MCh Somanna, Sampath, MCh Devi, Bhagavatula Indira, MS, MCh Vasudevan, Pillai Shibu, MCh Subbakrishna, Doddaballapur K., PhD Vasudev, Mandapati K., MD |
| description | Abstract Background It has been variably reported that patients who acutely present with low- or mixed-density blood on CT scan are associated with poor clinical outcome. The aim of the study was to correlate the presence or absence of mixed density within EDHs on CT scanning with the clinical outcome. Methods This is a retrospective study of a total of 109 patients with EDHs who were operated on from August 2001 to August 2002. The CT scans were reviewed and classified into 2 categories—predominantly hyperdense and mixed density. This was correlated with clinical details and outcome. Results In all, 43.2% (16/37) of patients in the mixed-density category presented with GCS of no more than 8 as compared with 23.6% (17/72) of patients in the hyperdense group ( P < .05). Mean hematoma volume in the mixed-density group was 72 cm3 as compared with 42 cm3 in the hyperdense group ( P < .05). Mortality rate was significantly higher in the mixed-density category (21.6% vs 4.2%, P < .05). Conclusion The study portends mixed density in EDH as a potent poor prognostic indicator. The mixed density of the clot probably indicates that the clot is rapidly increasing in size and requires even earlier and more aggressive treatment. |
| doi_str_mv | 10.1016/j.surneu.2007.10.032 |
| format | Article |
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The aim of the study was to correlate the presence or absence of mixed density within EDHs on CT scanning with the clinical outcome. Methods This is a retrospective study of a total of 109 patients with EDHs who were operated on from August 2001 to August 2002. The CT scans were reviewed and classified into 2 categories—predominantly hyperdense and mixed density. This was correlated with clinical details and outcome. Results In all, 43.2% (16/37) of patients in the mixed-density category presented with GCS of no more than 8 as compared with 23.6% (17/72) of patients in the hyperdense group ( P < .05). Mean hematoma volume in the mixed-density group was 72 cm3 as compared with 42 cm3 in the hyperdense group ( P < .05). Mortality rate was significantly higher in the mixed-density category (21.6% vs 4.2%, P < .05). Conclusion The study portends mixed density in EDH as a potent poor prognostic indicator. The mixed density of the clot probably indicates that the clot is rapidly increasing in size and requires even earlier and more aggressive treatment.</description><identifier>ISSN: 0090-3019</identifier><identifier>EISSN: 1879-3339</identifier><identifier>DOI: 10.1016/j.surneu.2007.10.032</identifier><identifier>PMID: 18328546</identifier><identifier>CODEN: SGNRAI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Cohort Studies ; Computed tomography ; Extradural hematoma ; Female ; Glasgow Coma Scale ; Hematoma volume ; Hematoma, Epidural, Cranial - diagnostic imaging ; Hematoma, Epidural, Cranial - mortality ; Hematoma, Epidural, Cranial - surgery ; Humans ; Hypodensity ; Male ; Medical sciences ; Mixed density ; Neurology ; Neurosurgery ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Factors ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Surgical neurology, 2009-02, Vol.71 (2), p.202-206</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-a60f0a9a37ef9079cf4c6fc980e5b2ee8a082f5656ad49b67a31daee35e7423d3</citedby><cites>FETCH-LOGICAL-c445t-a60f0a9a37ef9079cf4c6fc980e5b2ee8a082f5656ad49b67a31daee35e7423d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21121239$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18328546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pruthi, Nupur, MCh</creatorcontrib><creatorcontrib>Balasubramaniam, Anandh, MS, MCh</creatorcontrib><creatorcontrib>Chandramouli, Bangalore A., MCh</creatorcontrib><creatorcontrib>Somanna, Sampath, MCh</creatorcontrib><creatorcontrib>Devi, Bhagavatula Indira, MS, MCh</creatorcontrib><creatorcontrib>Vasudevan, Pillai Shibu, MCh</creatorcontrib><creatorcontrib>Subbakrishna, Doddaballapur K., PhD</creatorcontrib><creatorcontrib>Vasudev, Mandapati K., MD</creatorcontrib><title>Mixed-density extradural hematomas on computed tomography—prognostic significance</title><title>Surgical neurology</title><addtitle>Surg Neurol</addtitle><description>Abstract Background It has been variably reported that patients who acutely present with low- or mixed-density blood on CT scan are associated with poor clinical outcome. The aim of the study was to correlate the presence or absence of mixed density within EDHs on CT scanning with the clinical outcome. Methods This is a retrospective study of a total of 109 patients with EDHs who were operated on from August 2001 to August 2002. The CT scans were reviewed and classified into 2 categories—predominantly hyperdense and mixed density. This was correlated with clinical details and outcome. Results In all, 43.2% (16/37) of patients in the mixed-density category presented with GCS of no more than 8 as compared with 23.6% (17/72) of patients in the hyperdense group ( P < .05). Mean hematoma volume in the mixed-density group was 72 cm3 as compared with 42 cm3 in the hyperdense group ( P < .05). Mortality rate was significantly higher in the mixed-density category (21.6% vs 4.2%, P < .05). Conclusion The study portends mixed density in EDH as a potent poor prognostic indicator. The mixed density of the clot probably indicates that the clot is rapidly increasing in size and requires even earlier and more aggressive treatment.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Computed tomography</subject><subject>Extradural hematoma</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Hematoma volume</subject><subject>Hematoma, Epidural, Cranial - diagnostic imaging</subject><subject>Hematoma, Epidural, Cranial - mortality</subject><subject>Hematoma, Epidural, Cranial - surgery</subject><subject>Humans</subject><subject>Hypodensity</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mixed density</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Rate</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0090-3019</issn><issn>1879-3339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9u1DAQhy0EokvhDRDKBW5ZxnbixBckVPFPKuqh5Wx57cnWSxIvngR1bzwET8iT1NGuQOLSk6Wfvvlp_A1jLzmsOXD1dremOY04rwVAk6M1SPGIrXjb6FJKqR-zFYCGUgLXZ-wZ0Q4ApK71U3bGWynaulIrdv013KEvPY4UpkOBd1Oyfk62L25xsFMcLBVxLFwc9vOEvshJ3Ca7vz38-fV7n-J2jDQFV1DYjqELzo4On7Mnne0JX5zec_bt44ebi8_l5dWnLxfvL0tXVfVUWgUdWG1lg52GRruucqpzugWsNwKxtdCKrla1sr7SG9VYyb1FlDU2lZBenrM3x968x48ZaTJDIId9b0eMMxml2oorDRmsjqBLkShhZ_YpDDYdDAezyDQ7c5RpFplLmmXmsVen_nkzoP83dLKXgdcnwJKzfZfy7wP95QTnggupM_fuyGG28TNgMuQCZlM-JHST8TE8tMn_Ba4PY7bdf8cD0i7mkWzacEPCgLleDr_cHRrgUnIl7wFddayz</recordid><startdate>20090201</startdate><enddate>20090201</enddate><creator>Pruthi, Nupur, MCh</creator><creator>Balasubramaniam, Anandh, MS, MCh</creator><creator>Chandramouli, Bangalore A., MCh</creator><creator>Somanna, Sampath, MCh</creator><creator>Devi, Bhagavatula Indira, MS, MCh</creator><creator>Vasudevan, Pillai Shibu, MCh</creator><creator>Subbakrishna, Doddaballapur K., PhD</creator><creator>Vasudev, Mandapati K., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090201</creationdate><title>Mixed-density extradural hematomas on computed tomography—prognostic significance</title><author>Pruthi, Nupur, MCh ; Balasubramaniam, Anandh, MS, MCh ; Chandramouli, Bangalore A., MCh ; Somanna, Sampath, MCh ; Devi, Bhagavatula Indira, MS, MCh ; Vasudevan, Pillai Shibu, MCh ; Subbakrishna, Doddaballapur K., PhD ; Vasudev, Mandapati K., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-a60f0a9a37ef9079cf4c6fc980e5b2ee8a082f5656ad49b67a31daee35e7423d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Computed tomography</topic><topic>Extradural hematoma</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Hematoma volume</topic><topic>Hematoma, Epidural, Cranial - diagnostic imaging</topic><topic>Hematoma, Epidural, Cranial - mortality</topic><topic>Hematoma, Epidural, Cranial - surgery</topic><topic>Humans</topic><topic>Hypodensity</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mixed density</topic><topic>Neurology</topic><topic>Neurosurgery</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Survival Rate</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Pruthi, Nupur, MCh</creatorcontrib><creatorcontrib>Balasubramaniam, Anandh, MS, MCh</creatorcontrib><creatorcontrib>Chandramouli, Bangalore A., MCh</creatorcontrib><creatorcontrib>Somanna, Sampath, MCh</creatorcontrib><creatorcontrib>Devi, Bhagavatula Indira, MS, MCh</creatorcontrib><creatorcontrib>Vasudevan, Pillai Shibu, MCh</creatorcontrib><creatorcontrib>Subbakrishna, Doddaballapur K., PhD</creatorcontrib><creatorcontrib>Vasudev, Mandapati K., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pruthi, Nupur, MCh</au><au>Balasubramaniam, Anandh, MS, MCh</au><au>Chandramouli, Bangalore A., MCh</au><au>Somanna, Sampath, MCh</au><au>Devi, Bhagavatula Indira, MS, MCh</au><au>Vasudevan, Pillai Shibu, MCh</au><au>Subbakrishna, Doddaballapur K., PhD</au><au>Vasudev, Mandapati K., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mixed-density extradural hematomas on computed tomography—prognostic significance</atitle><jtitle>Surgical neurology</jtitle><addtitle>Surg Neurol</addtitle><date>2009-02-01</date><risdate>2009</risdate><volume>71</volume><issue>2</issue><spage>202</spage><epage>206</epage><pages>202-206</pages><issn>0090-3019</issn><eissn>1879-3339</eissn><coden>SGNRAI</coden><abstract>Abstract Background It has been variably reported that patients who acutely present with low- or mixed-density blood on CT scan are associated with poor clinical outcome. The aim of the study was to correlate the presence or absence of mixed density within EDHs on CT scanning with the clinical outcome. Methods This is a retrospective study of a total of 109 patients with EDHs who were operated on from August 2001 to August 2002. The CT scans were reviewed and classified into 2 categories—predominantly hyperdense and mixed density. This was correlated with clinical details and outcome. Results In all, 43.2% (16/37) of patients in the mixed-density category presented with GCS of no more than 8 as compared with 23.6% (17/72) of patients in the hyperdense group ( P < .05). Mean hematoma volume in the mixed-density group was 72 cm3 as compared with 42 cm3 in the hyperdense group ( P < .05). Mortality rate was significantly higher in the mixed-density category (21.6% vs 4.2%, P < .05). Conclusion The study portends mixed density in EDH as a potent poor prognostic indicator. The mixed density of the clot probably indicates that the clot is rapidly increasing in size and requires even earlier and more aggressive treatment.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18328546</pmid><doi>10.1016/j.surneu.2007.10.032</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Cohort Studies Computed tomography Extradural hematoma Female Glasgow Coma Scale Hematoma volume Hematoma, Epidural, Cranial - diagnostic imaging Hematoma, Epidural, Cranial - mortality Hematoma, Epidural, Cranial - surgery Humans Hypodensity Male Medical sciences Mixed density Neurology Neurosurgery Predictive Value of Tests Prognosis Retrospective Studies Risk Factors Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Rate Tomography, X-Ray Computed Treatment Outcome |
| title | Mixed-density extradural hematomas on computed tomography—prognostic significance |
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