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Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2015; 34(01): 025-029
DOI: 10.1055/s-0035-1547377
Original Article | Artigo Original
Thieme Publicações Ltda Rio de Janeiro, Brazil

Hematoma subdural crônico em adultos jovens

Subdural Hematoma Chronic in Young Adults
Carlos Umberto Pereira
1   Professor Doutor Adjunto do Departamento de Medicina da Universidade Federal de Sergipe (UFS), Aracaju, SE, Brasil; Neurocirurgião do Serviço de Neurocirurgia do Hospital de Urgências de Sergipe (HUSE), Aracaju, SE, Brasil
,
José Anísio Santos Junior
2   Acadêmico de Medicina da UFS, Aracaju, SE, Brasil
,
Ana Cristina Lima Santos
2   Acadêmico de Medicina da UFS, Aracaju, SE, Brasil
,
Rodrigo Oliveira Passos
2   Acadêmico de Medicina da UFS, Aracaju, SE, Brasil
› Author Affiliations
Further Information

Publication History

31 October 2014

01 November 2014

Publication Date:
29 April 2015 (online)

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Resumo

Objetivo O hematoma subdural crônico em adultos jovens é relativamente frequente, sendo tipicamente encontrado em idosos. Os principais fatores relacionados ao hematoma subdural crônico em adultos jovens são: derivação ventriculoperitoneal, cisto aracnóideo, uso de droga anticoagulante, coagulopatias e esportes vigorosos. O prognóstico depende da idade do paciente, do estado neurológico na admissão, das doenças sistêmicas associadas, assim como do diagnóstico preciso e tratamento adequado.

Métodos Foram incluídos pacientes de ambos os gêneros, da faixa etária de 20 a 45 anos de idade, com diagnóstico confirmado de hematoma subdural crônico.

Resultados Foram analisados 34 pacientes no período de janeiro de 2005 a dezembro de 2013. O gênero masculino teve 25 e o feminino 9 casos. As causas foram: traumatismo cranioencefálico (20 pacientes), etilismo (7), crises convulsivas (3) e raquianestesia (2); as causas permaneceram desconhecidas em 2 pacientes. A tomografia computadorizada foi realizada em todos os pacientes e a ressonância magnética em 2 deles. Localização unilateral em 30 e bilateral em 4. Foram tratados cirurgicamente 28 pacientes e 6 receberam tratamento conservador. Tiveram boa evolução 27 pacientes, 4 apresentaram déficit neurológico focal, 2 apresentaram crise convulsiva e houve um óbito.

Conclusões O hematoma subdural crônico é frequente em adultos jovens. O traumatismo cranioencefálico e etilismo crônico foram as principais causas de hematoma subdural crônico em jovens. Acomete mais o gênero masculino. O tratamento de escolha é cirúrgico. O prognóstico é bom.

Abstract

Objective Chronic subdural hematoma in young adults is relatively common, typically found in the elderly. The main factors related to chronic subdural hematoma in young adults are: ventriculoperitoneal shunt, arachnoid cyst, anticoagulant drug, coagulopathies and vigorous sports. The prognosis depends on the patient's age, neurological status on admission, associated systemic diseases, as well as the accurate diagnosis and proper treatment.

Methods Patients of both sexes were included with 20-45 years of age with a confirmed diagnosis of chronic subdural hematoma.

Results 34 patients were analyzed from January 2005 to December 2013. Males reported 25 cases and 9 female. The causes were 20 traumatic brain injury, alcoholism 7, 3 seizures, spinal anesthesia 2 and unknown 2 patients. Computed tomography was performed in all patients and magnetic resonance imaging in 2 cases. Location unilateral in 30 and bilateral in 4. Surgically and 28 patients were treated conservative 6. Twenty-seven patients improved, four had focal neurological deficits, seizures two and one case died.

Conclusions The chronic subdural hematoma is common in young adults. The craniocerebral trauma and chronic alcohol consumption were the main causes of chronic subdural hematoma in young. It affects more males. The treatment of choice is surgery. The prognosis is good.

Palavras-chave

hematoma subdural crônico - adultos jovens - diagnóstico - prognóstico

Keywords

hematoma subdural chronic - young adults - diagnosis - prognosis
 

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