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Is a Close Follow-Up Computed Tomography Necessary for Acute Falcine and Tentorial Subdural Hematoma?
- Source :
-
Journal of computer assisted tomography [J Comput Assist Tomogr] 2022 Jan-Feb 01; Vol. 46 (1), pp. 97-102. - Publication Year :
- 2022
-
Abstract
- Objective: This study aimed to assess the changes and values on follow-up computed tomography (F/U-CT) for isolated falcine (F-SDH) and tentorial (T-SDH) subdural hematomas (SDHs).<br />Method: Fifty-four cases of isolated F-SDH and/or T-SDH were retrospectively reviewed. Subdural hematoma morphology, mass effect on the adjacent parenchyma, and interval change at F/U-CT were evaluated. Subdural hematoma size was measured parallel and perpendicular to the falx/tentorium (long or short axis, respectively).<br />Results: Short-axis increase on F/U-CT was seen only in 5 F-SDHs (16%) and 7 T-SDHs (19%), with a maximum of a 2-mm increase. Long-axis growth was more prominent and frequent, seen in 18 F-SDH patients (56.2%) and 19 T-SDH patients (51.4%), with maximum change of up to 43 mm. Falcine SDH and T-SDH were ipsilateral and contiguous in 77.8% of patients. Minimal mass effect was seen in 13 patients (24.1%), which was resolved or stable on F/U-CT. Anticoagulation did not affect SDH size. No patients required neurosurgery or died.<br />Conclusions: Based on our limited data, the current standard of F/U-CT may be unnecessary in patients with isolated F-SDH and/or T-SDH, which expand minimally along the short axis without a significant mass effect. Characteristic anatomic structure of the tentorium and falx, and their connectivity may direct SDH expansion and limit mass effect as well as injury to the adjacent parenchyma.<br />Competing Interests: The authors declare no conflict of interest.<br /> (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1532-3145
- Volume :
- 46
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of computer assisted tomography
- Publication Type :
- Academic Journal
- Accession number :
- 35099141
- Full Text :
- https://doi.org/10.1097/RCT.0000000000001254