2013 Volume 36 Issue 2 Pages 196-201
Background and Purpose: Chronic hemodialysis (HD) has been known as a risk factor for chronic subdural hematoma (CSH), although clinical characteristics of CSH have not been clarified in HD patients. In this paper, clinical characterisitics of CSH are investigated in HD patients, and clinical problems of those are discussed.
Materials and Methods: Twenty-seven HD patients with CSH are involved in this study. Age, gender, cause of trauma, pre-conditioning with anti-coagulant ⁄ platelet therapy, symptom, Glasgow Coma Scale (GCS) scores, Glasgow Outcome Scale (GOS) scores, recurrence rate, complications are summarized from medical records, to compare with 348 non-HD cases with CSH as control.
Result: Pre-traumatic conditioning with anti-coagulants or -platelets is more frequent in HD than control. Initial symptoms, as well as GCS scores, are more severe in HD than control. GOS scores are significantly worse in HD than control, although more than 85% of patients result in favorable outcome even in HD patients. Mean duration of administration is significantly longer in HD than control. Recurrence rate seems higher in HD than control, but not significant. Main reasons of poor outcome are cerebral infarction, cardiac failure, pneumonia, and so on.
Conclusion: Early diagnosis and treatments may be important to improve outcome of CSH in HD patients, as well as appropriate treatments for both coagulopathy induced by preconditioning with anti-coagulants ⁄ -platelet therapy, and general complications.
