Citation

Cragun BN, Noorbakhsh MR, Hite Philp F, Suydam ER, Ditillo MF, Philp AS, Murdock AD. J. Surg. Res. 2020; 249: 99-103.

Affiliation

Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.jss.2019.12.019

PMID

31926402

Abstract

BACKGROUND: Guidelines for management of intracranial hemorrhage do not account for bleed location. We hypothesize that parafalcine subdural hematoma (SDH), as compared to convexity SDH, is a distinct clinical entity and these patients do not benefit from critical care monitoring or repeat imaging.

METHODS: We identified patients presenting to a single level I trauma center with isolated head injuries from February 2016 to August 2017. We identified 88 patients with isolated blunt traumatic parafalcine SDH and 228 with convexity SDH.

RESULTS: Demographics, comorbidities, and use of antiplatelet and anticoagulant agents were similar between the groups. As compared to patients with convexity SDH, patients with parafalcine SDH had a significantly lower incidence of radiographic progression, and had no cases of neurologic deterioration, neurosurgical intervention, or mortality (all P < 0.005). Compared to patients admitted to the intensive care unit, patients with parafalcine SDH admitted to the floor had a shorter length of stay (2.0 ± 1.6 versus 3.8 ± 2.9 d, P < 0.005) with no difference in outcomes.

CONCLUSIONS: Patients presenting with a parafalcine SDH are a distinct and relatively benign clinical entity as compared to convexity SDH and do not benefit from repeat imaging or intensive care unit admission.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

ICH; Interhemispheric; Parafalcine; SDH; TBI