Your browser doesn't support javascript.
loading
Comparing surgical outcomes: Craniotomy versus decompressive craniectomy in acute subdural hematoma - A systematic review and meta-analysis.
Nadeem, Abdullah; Siddiqui, Tasmiyah; Rais, Taruba; Munsab, Rabbia; Habib, Ashna; Afridi, Eesha Khan; Shariq, Fariha.
Afiliación
  • Nadeem A; Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
  • Siddiqui T; Dow University of Health Sciences, Mission Road, Karachi, Pakistan.
  • Rais T; Dow University of Health Sciences, Mission Road, Karachi, Pakistan.
  • Munsab R; Dow University of Health Sciences, Mission Road, Karachi, Pakistan.
  • Habib A; Dow University of Health Sciences, Mission Road, Karachi, Pakistan.
  • Afridi EK; Jinnah Sindh Medical University, Karachi, Pakistan.
  • Shariq F; Karachi Medical and Dental College, Karachi, Pakistan.
World Neurosurg X ; 23: 100368, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38623315
ABSTRACT

Introduction:

Acute subdural hematomas (SDH) pose a significant health risk, often resulting from traumatic head injuries. The choice between surgical interventions, craniotomy, and decompressive craniectomy, remains a subject of debate. This meta-analysis aims to compare outcomes and guide clinical decision-making.

Methods:

Following PRISMA guidelines, a comprehensive literature search was conducted in databases such as Ovid Medline, PubMed, and Cochrane, up to December 2023. Selection criteria included studies comparing craniotomy and decompressive craniectomy for acute SDH. Data extraction utilized the Newcastle-Ottawa Quality Assessment Tool, and statistical analysis employed the random-effects model.

Results:

The meta-analysis included 17 studies and 6848 patients. Craniotomy demonstrated a significant reduction in mortality rates (RR 0.80, 95% CI 0.73-0.89, P < 0.0001). GCS scores favored craniotomy for severe cases. GOS outcomes showed a trend favoring craniotomy, particularly in good recovery (RR 1.34, 95% CI 1.04-1.74, P = 0.03). Additional factors explored included co-existing sub-epidural hematoma, mydriasis, extracranial injuries, residual SDH, revision rates, and intracranial pressure.

Conclusion:

The meta-analysis suggests that craniotomy may be a favorable surgical strategy for acute SDH, displaying a significant decrease in mortality rates and a lower risk of raised intracranial pressure. However, the nuanced nature of outcomes emphasizes the need for a tailored approach, considering broader clinical contexts. Future research should address limitations and provide a basis for well-informed clinical decision-making.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg X Año: 2024 Tipo del documento: Article País de afiliación: Pakistán Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg X Año: 2024 Tipo del documento: Article País de afiliación: Pakistán Pais de publicación: Estados Unidos