Abstract Details

Title Traumatic Interhemispheric Subdural Hematomas – clinical significance, management and outcome.

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-015

Objective

Our study aims at clarifying the exact incidence of IHSDH and describing their clinical presentation and evolution, so that a management algorithm could be proposed for this pathology.

Background Interhemispheric subdural hematoma (IHSDH) are a subset of subdural hematomas (SDH) and thought to be rare. Surgical management of these lesions presents a particular challenge as they are in close proximity to the sagittal sinus and numerous bridging veins. IHSDH are poorly characterized clinically, and their exact incidence is unknown.

Design/Methods We reviewed admissions from December 2009 to 2013 at a Level I trauma center. Of 2165 admissions, 1182 patients had acute traumatic subdural hematomas (SDH), 420 patients had IHSDHs, 35 of which were ≥8 mm in width. Clinical characteristics of all patients with SDH and IHSDH were collected, and a complete chart review was performed for the 35 patients with a IHSDSH that was larger than 8 mm in width.

Results HSDH were isolated in 16 (3.8%) of the cases. Average age was 61.7 ± 21.5 years for all IHSDH, and 77.1 ± 10.4 for large IHSDH (p < 0.001). For large IHSDH, a transient loss of consciousness (LOC) occurred in 51.5% of individuals. Post-traumatic amnesia (PTA) was reported in 47.8% of cases, while motor weakness was present in 37.9% of patients. Numbness and anicosoria were present in respectively 17.4 and 14.3% of cases. Five large IHSDH patients presented with motor deficits directly related to the IHSDH, and weakness resolved in four of these five individuals. Four factors were associated with a lower Glasgow outcome scale (GOS) score and a higher mortality in large IHSDH patients: low GCS score at presentation (p < 0.001), loss of consciousness, post-traumatic amnesia, and anicosoria.

Conclusions

IHSDHs are often referred to as rare entities. Our results show they are common. Conservative management is appropriate to manage most IHSDHs.

Authors/Disclosures
Etienne Leveille, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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Abstract Details