New horizons in subdural haematoma.
Subdural haematoma (SDH) is a common injury sustained by older people living with frailty and multimorbidity, and typically following falls from a standing height. Anticoagulant and antiplatelet use are commonly indicated in older people with SDH, but few data inform decision-making surrounding thes...
| Publicado en: | Age & Ageing Vol. 52; no. 12; pp. 1 - 11 |
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| Autores principales: | , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Dec2023
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=174575463&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 174575463 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Dec2023 vid: 52 iid: 12 pid: 622 pub: Oxford University Press / USA artinfo: ui: 174575463 10.1093/ageing/afad240 ppf: 1 ppct: 10 formats: tig: atl: New horizons in subdural haematoma. aug: au: Rickard, Frances Gale, John Williams, Adam Shipway, David affil: Consultant Geriatrician , Geriatric Major Trauma, North Bristol NHS Trust, Bristol , UK Clinical Fellow in Geriatric Major Trauma , North Bristol NHS Trust, Bristol , UK Consultant Neurosurgeon, Department of Neurosurgery , North Bristol NHS Trust, Bristol , UK Honorary Senior Clinical Lecturer , University of Bristol, Bristol, UK su: United Kingdom Decision making Disease risk factors Thrombosis complications Frail elderly Intracranial hemorrhage Anticoagulants Surgical decompression Therapeutic embolization Disease incidence Subdural hematoma Accidental falls Platelet aggregation inhibitors Comorbidity Disease complications sug: subj: Decision making Disease risk factors United Kingdom Thrombosis complications Frail elderly Intracranial hemorrhage Anticoagulants Surgical decompression Therapeutic embolization Disease incidence Subdural hematoma Accidental falls Platelet aggregation inhibitors Comorbidity Disease complications keyword: frailty major trauma older people subdural haematoma traumatic brain injury frailty major trauma older people subdural haematoma traumatic brain injury ab: Subdural haematoma (SDH) is a common injury sustained by older people living with frailty and multimorbidity, and typically following falls from a standing height. Anticoagulant and antiplatelet use are commonly indicated in older people with SDH, but few data inform decision-making surrounding these agents in the context of intracranial bleeding. Opposing risks of rebleeding and thrombosis must therefore be weighed judiciously. Decision-making can be complex and requires detailed awareness of the epidemiology to ensure the safest course of action is selected for each patient. Outcomes of surgical decompression in acute SDH are very poor in older people. However, burr hole drainage can be safe and effective in older adults with symptomatic chronic SDH (cSDH). Such patients need careful assessment to ensure symptoms arise from cSDH and not from coexisting medical pathology. Furthermore, the emerging treatment of middle meningeal artery embolisation offers a well-tolerated, minimally invasive intervention which may reduce the risks of rebleeding in older adults. Nonetheless, UK SDH management is heterogenous, and no accepted UK or European guidelines exist at present. Further randomised trial evidence is required to move away from clinical practice based on historic observational data. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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