Improving care in elderly neurosurgery initiative guideline on management of chronic subdural haematoma in older people-relevance for the geriatrician.

Chronic subdural haematoma (cSDH) is a common subtype of traumatic brain injury, typically affecting older people living with frailty and multimorbidity. Until now, no published guideline has existed internationally to guide management, perhaps explaining why the care of the older cSDH patient varie...

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Publicado en:Age & Ageing Vol. 54; no. 1; pp. 1 - 6
Autores principales: Rickard, Frances, Cox, Anthony, Willliams, Adam, Mortimer, Alex, Wigfield, Crispin, Shipway, David
Formato: Artículo
Publicado: Oxford University Press / USA Jan2025
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Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Improving care in elderly neurosurgery initiative guideline on management of chronic subdural haematoma in older people-relevance for the geriatrician.
      aug:
        au:
          Rickard, Frances
          Cox, Anthony
          Willliams, Adam
          Mortimer, Alex
          Wigfield, Crispin
          Shipway, David
        affil:
          North Bristol NHS Trust – Geriatric Medicine, Southmead Hospital, Southmead Road, Bristol BS10 5NB, UK
          North Bristol NHS Trust – Interventional Neuro-radiology, Bristol, UK
          North Bristol NHS Trust – Neurosurgery, Bristol, UK
          University of Bristol, Bristol BS8 1QU, UK
          British Geriatrics Society Perioperative Medicine (POPS) SIG, London, UK
      su:
        Elder care
        Chronic diseases
        Old age
        Medical protocols
        Postoperative care
        Neurosurgery
        Therapeutic embolization
        Tertiary care
        Subdural hematoma
        Brain injuries
        Quality assurance
        Meningeal artery
      sug:
        subj:
          Elder care
          Chronic diseases
          Old age
          Continuing Care Retirement Communities
          Specialty (except Psychiatric and Substance Abuse) Hospitals
          Medical protocols
          Postoperative care
          Neurosurgery
          Therapeutic embolization
          Tertiary care
          Subdural hematoma
          Brain injuries
          Quality assurance
          Meningeal artery
      keyword:
        burr hole trephination
        chronic
        chronic subdural haematoma
        embolization
        geriatricians
        hematoma
        meningeal arteries
        middle meningeal artery embolisation
        neurosurgery specialty
        neurosurgical procedures
        neurotrauma
        older adult
        older people
        operative
        subdural
        surgical procedures
        burr hole trephination
        chronic
        chronic subdural haematoma
        embolization
        geriatricians
        hematoma
        meningeal arteries
        middle meningeal artery embolisation
        neurosurgery specialty
        neurosurgical procedures
        neurotrauma
        older adult
        older people
        operative
        subdural
        surgical procedures
      ab: Chronic subdural haematoma (cSDH) is a common subtype of traumatic brain injury, typically affecting older people living with frailty and multimorbidity. Until now, no published guideline has existed internationally to guide management, perhaps explaining why the care of the older cSDH patient varies between neurosurgical centres. The Improving Care in Elderly Neurosurgery Initiative guideline is the first guideline dedicated to the care of patients with cSDH across the entire patient pathway, from initial presentation through to rehabilitation and discharge after surgery. It includes specific recommendations for those patients not requiring surgery who, in the UK, are mostly managed in satellite hospitals away from the tertiary neurosurgical centre. It therefore has relevance to clinicians across the entire UK and also potentially to a broader international audience. In this guideline commentary we summarise the key points for geriatricians and those allied specialties such as acute medicine who deliver care to a large proportion of patients with cSDH. We discuss issues and limitations relating to guideline development, in particular in the rapidly evolving field of Middle Meningeal Artery Embolisation. We also comment on factors which may influence guideline implementation and future service development. Finally we call for some form of national registry in older people sustaining SDH, which may need to be supported by financial incentives to drive investment in services for this historically neglected patient group.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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