Management of acute subdural hematomas in infants : intrathecal infusion streptokinase for clot lysis combined with subdural to subgaleal shunt
OBJECT: Subdural hematomas (SDHs) in full-term infants have the potential to cause death or lifelong disability. We report management and outcomes of eight cases of newborn with large SDH treated by streptokinase (SK) lavage and drainage.
MATERIALS AND METHODS: Between 2003 and 2006, eight infants with large acute SDH with focal or diffuse hypodensity showing signs and symptoms of neurological deterioration were treated by drainage and subdural SK lavage. There were eight full-term infants, five boys and three girls, with ages between 10 days and 2 months. Head injuries were shaken baby syndrome in three cases, fall from height in three cases, caused by traffic accident in one case, and reportedly not due to trauma in one case. In all patients, SDHs were unilateral. We used a new surgical approach, SDH evacuation, involving the subdural instillation of SK for lysis and after drainage of acute SDH in infants. Follow-up in the series ranged from 1 to 42 months (average 30 months). There was no mortality in this series, neither in the early postoperative period nor in the follow-up period. Five patients of this series lead a normal life; two children were mildly neurodevelopmentally delayed.
CONCLUSION: Subdural infusion of SK followed by drainage may be as safe and effective for treatment of acute SDHs in infants as other reported methods.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2008 |
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| Erschienen: |
2008 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
|---|---|
| Enthalten in: |
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery - 24(2008), 4 vom: 30. Apr., Seite 437-42 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Larionov, Sergey N [VerfasserIn] |
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| Themen: |
Clinical Trial |
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| Anmerkungen: |
Date Completed 01.08.2008 Date Revised 13.11.2018 published: Print-Electronic Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM174032382 |
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| LEADER | 01000naa a22002652 4500 | ||
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| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Larionov, Sergey N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Management of acute subdural hematomas in infants |b intrathecal infusion streptokinase for clot lysis combined with subdural to subgaleal shunt |
| 264 | 1 | |c 2008 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 01.08.2008 | ||
| 500 | |a Date Revised 13.11.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECT: Subdural hematomas (SDHs) in full-term infants have the potential to cause death or lifelong disability. We report management and outcomes of eight cases of newborn with large SDH treated by streptokinase (SK) lavage and drainage | ||
| 520 | |a MATERIALS AND METHODS: Between 2003 and 2006, eight infants with large acute SDH with focal or diffuse hypodensity showing signs and symptoms of neurological deterioration were treated by drainage and subdural SK lavage. There were eight full-term infants, five boys and three girls, with ages between 10 days and 2 months. Head injuries were shaken baby syndrome in three cases, fall from height in three cases, caused by traffic accident in one case, and reportedly not due to trauma in one case. In all patients, SDHs were unilateral. We used a new surgical approach, SDH evacuation, involving the subdural instillation of SK for lysis and after drainage of acute SDH in infants. Follow-up in the series ranged from 1 to 42 months (average 30 months). There was no mortality in this series, neither in the early postoperative period nor in the follow-up period. Five patients of this series lead a normal life; two children were mildly neurodevelopmentally delayed | ||
| 520 | |a CONCLUSION: Subdural infusion of SK followed by drainage may be as safe and effective for treatment of acute SDHs in infants as other reported methods | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Streptokinase |2 NLM | |
| 650 | 7 | |a EC 3.4.- |2 NLM | |
| 700 | 1 | |a Sorokovikov, Vladimir A |e verfasserin |4 aut | |
| 700 | 1 | |a Novozilov, Vladimir A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery |d 1993 |g 24(2008), 4 vom: 30. Apr., Seite 437-42 |w (DE-627)NLM012695971 |x 1433-0350 |7 nnns |
| 773 | 1 | 8 | |g volume:24 |g year:2008 |g number:4 |g day:30 |g month:04 |g pages:437-42 |
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