gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Management and outcome of patients with acute traumatic subdural hematoma on marcumar therapy

Management und Outcome von Patienten mit akuten traumatischen Subduralhämatomen unter Marcumar-Therapie

Meeting Abstract

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  • corresponding author C. Senft - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • R. Gerlach - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • T. Schuster - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.08.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc118.shtml

Veröffentlicht: 11. April 2007

© 2007 Senft et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To report our management and outcome of patients suffering from acute traumatic subdural haematoma (aSDH) while under anticoagulation therapy with marcumar.

Methods: We retrospectively analysed the medical history, preoperative and surgical treatment and coagulation parameters of 112 consecutive patients referred with aSHD between June 2002 and June 2006 and treated surgically.

Results: Among the 112 consecutive patients treated surgically for aSDH haematoma, 4 patients (3,6%) were on marcumar without a history of trauma and were therefore excluded from the study. Among the remaining 108 patients with aSDH, 11 (10.2%) patients were on anticoagulation with marcumar. These patients were older, with a higher percentage of females in this group. Median initial PT level was 23%, median pre-operative GCS was 7. Pre-surgical treatment consisted of administration of PPSB, ATIII, vitamin K and FFP’s. No relevant re-bleedings were observed with our substitution management. Four patients (36.4%) died within the first week after trauma due to the trauma and refractory increased intracranial pressure (n=3) or pneumonia (n=1). In the remaining 7 patients median GCS was 11 after 7 days. One patient died two months after trauma due to heart failure. Median GOS six months after trauma was 4, and the overall mortality was 45%.

Conclusions: The percentage of patients with anticoagulation therapy is surprisingly high among those patients with aSDH. Despite a higher age and increased co-morbidity, the outcome of these patients seems to be similar or even better compared to patients without therapeutic anticoagulation and aSDH when immediate replacement therapy and urgent surgery are carried out.