Causes and Trauma Apportionment Score of Chronic Subdural Hematoma.
10.13004/kjnt.2018.14.2.61
- Author:
Kyeong Seok LEE
1
;
Seok Mann YOON
;
Jae Sang OH
;
Hyuk Jin OH
;
Jae Jun SHIM
;
Jae Won DOH
Author Information
1. Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. ksleens@sch.ac.kr
- Publication Type:Original Article
- Keywords:
Aging;
Causality;
Craniocerebral trauma;
Hematoma, subdural, chronic;
Insurance;
Intracranial pressure
- MeSH:
Adult;
Aging;
Craniocerebral Trauma;
Hematoma, Subdural, Chronic*;
Humans;
Insurance;
Intracranial Pressure;
Medical Records;
Precipitating Factors;
Retrospective Studies
- From:Korean Journal of Neurotrauma
2018;14(2):61-67
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The pathophysiology of chronic subdural hematoma (CSH) is not yet clear. Trauma alone is not sufficient to result in CSH in young individuals, while a trivial injury can result in CSH in older adults. Although the causality and apportionment of trauma are important issues in CSH, especially in terms of insurance, it is too obscure to solve all struggles. METHODS: There are three key factors for producing CSH. First, CSH necessitates a potential subdural reservoir. Other important precipitating factors are trauma and coagulopathy. However, these factors are not sufficient to cause CSH development. The trauma apportionment score (TAS) can be used to compare the relative importance of these three factors. Here, we applied the TAS to 239 consecutive cases of CSH. We retrospectively obtained the patients' history and laboratory results from their medical records. RESULTS: The TAS ranged from −5 to 5. The most common score was 0. If we defined the cause of CSH as being combined when the TAS was 0, then the cause was combined in 30 cases (12.6%). If we extended the criteria for a combined cause from 0 to −1 to 1, the cause was combined in 107 cases (44.8%). Regardless of the criteria used, traumatic CSHs were more common than were spontaneous CSHs. Spontaneous CSHs were more common in older than in younger patients (p < 0.01, Fisher's exact test). CONCLUSION: The TAS is a useful tool for differentiating the causality of CSH.
