Improving Clinical Outcomes from Acute Subdural Hematomas with the Emergency Preoperative Administration of High Doses of Mannitol: A Randomized Trial

@article{Cruz2001ImprovingCO,
  title={Improving Clinical Outcomes from Acute Subdural Hematomas with the Emergency Preoperative Administration of High Doses of Mannitol: A Randomized Trial},
  author={Julio Cruz and Giulio Minoja and Kazuo Okuchi},
  journal={Neurosurgery},
  year={2001},
  volume={49},
  pages={864-871}
}
OBJECTIVETo evaluate clinical outcomes and postoperative physiological findings for comatose patients with acute subdural hematomas who received preoperative high-dose mannitol (HDM) versus conventional-dose mannitol treatment. METHODSOne hundred seventy-eight adult patients with non-missile, traumatic, acute, subdural hematomas were prospectively and randomly assigned to receive emergency, preoperative, intravenous HDM treatment (91 patients), compared with a control group treated with a lower… Expand
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Major Clinical and Physiological Benefits of Early High Doses of Mannitol for Intraparenchymal Temporal Lobe Hemorrhages with Abnormal Pupillary Widening: A Randomized Trial
TLDR
Early preoperative HDM administration in the emergency room was associated with improved clinical outcomes for adult comatose patients with acute, nonmissile, intraparenchymal temporal lobe hemorrhages and associated abnormal pupillary widening. Expand
Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial.
TLDR
Ultra-early high-dose mannitol administration in the emergency room is the first known treatment strategy significantly to reverse recent clinical signs of impending brain death, and also to contribute directly to improved long-term clinical outcomes for these patients who have previously been considered unsalvageable. Expand
Emergent Single Burr Hole Evacuation for Traumatic Acute Subdural Hematoma with Cerebral Herniation: A Retrospective Cohort Comparison Analysis.
TLDR
Emergent single burr hole evacuation in combination with decompressive craniectomy surgery is a useful treatment for ASDH with cerebral herniation, which can achieve reduction of intracranial pressure as soon as possible and improve the prognosis. Expand
Predictors for functional recovery and mortality of surgically treated traumatic acute subdural hematomas in 256 patients.
  • Kyu-Hong Kim
  • Medicine
  • Journal of Korean Neurosurgical Society
  • 2009
TLDR
Functional recovery was more likely to be achieved in patients who were under 40 years of age, victims of motor vehicle collision and having preoperative reactive pupils, higher GCS score and the absence of ABS during surgery. Expand
Results of single burr hole drainage for acute subdural hematoma with non-reactive pupil.
TLDR
Emergency burr hole drainage should still be considered in patients with ASDH showing bilateral non-reactive pupils and one pupil 4 mm, according to the authors. Expand
Acute neurosurgical management of traumatic brain injury and spinal cord injury
TLDR
In neurotrauma some established treatments have been re-examined and their efficacy proven, whereas others that were once considered the standard of care in SCI, such as methylprednisolone, have been questioned. Expand
Osmolar therapy in pediatric traumatic brain injury*
TLDR
Hypertonic saline and mannitol are used less in infants than in older children, and the substantial amount of sustained osmolar therapy without intracranial pressure monitoring suggest opportunities to improve the quality of pediatric traumatic brain injury care. Expand
The Neurocritical and Neurosurgical Care of Subdural Hematomas
TLDR
Concerns for acute, subacute, and chronic SDHs are discussed and how presentation and management may change in both the elderly and pediatric populations are discussed. Expand
Mannitol for acute traumatic brain injury.
TLDR
High-doseMannitol may be preferable to conventional-dose mannitol in the acute management of comatose patients with severe head injury and ICP-directed treatment shows a small beneficial effect compared to treatment directed by neurological signs and physiological indicators. Expand
Formula for Use of Mannitol in Patients with Intracerebral Haemorrhage and High Intracranial Pressure
TLDR
The total mannitol dosage required for individual patients with ICH and elevated ICP can be calculated by considering the location of the haemorrhage, the volume of thehaematoma and the pretreated ICP reading. Expand
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