title: Acute subdural hematoma in patients with medication associated with risk of hemorrhage.
abstract: The characteristics of 90 cases of acute subdural hematoma were analyzed in 25 patients taking medication related to bleeding tendency, the bleeding tendency group, and 65 patients without such medication, the control group. Acute subdural hematoma was significantly associated with over-turning or without accident in the bleeding tendency group (92%) compared with the control group (56.9%). The time from trauma to admission was significantly longer in the bleeding tendency group (32.7 hours) compared with the control group (9.7 hours). The mean Glasgow Coma Scale score on admission was 13.0 points in the bleeding tendency group and was significantly better than 10.9 points in the control group. The international normalized ratio of prothrombin time on admission was 3.59 in the patients treated with warfarin. All patients taking warfarin received reversal agents and this value decreased significantly to 1.38. In the bleeding tendency group, hematoma size increased in 20% after the operation, almost the same as in the control group (25%). Although good recovery tended to be observed less frequently in the bleeding tendency group than in the control group, the mean age of the bleeding tendency group was significantly higher than that of the control group, so the prognosis might be affected by this age-related factor. Cautious diagnosis, follow-up imaging, and strict management are mandatory in patients with bleeding tendency.
authors.affiliation: Department of Neurosurgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan. oya3776@arrow.ocn.ne.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Oyama
authors.forename: Akira
authors.initials: A
authors.lastname: Kito
authors.forename: Hideki
authors.initials: H
authors.lastname: Maki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hattori
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Wada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity / Q000639:trends; D003244:Consciousness Disorders / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011859:Radiography; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors