Abstract:
OBJECTIVE:This study provides the first United States (US) national data regarding frequency, cost and mortality rate of epidural hematoma (EDH) and determines the factors affecting the morbidity and deaths in the patients with EDH undergoing surgical evacuation. METHODS:A retrospective analysis was performed by searching the Nationwide Inpatient Sample (NIS) from 2003 to 2010, the largest all payer database of non-federal community hospitals in the US. All cases of EDH were indentified using ICD-9 codes. RESULTS:A total of 5189 admissions were identified in the NIS database, and incidence was highest in the second decade (33.4%). The median length of stay in the hospital was about 4 days in each year (2003-2010) without significant difference. The percent of discharge disposition other than home was about 2-3% in the entire cohort, with the highest in 2009 (3%). The average cost per admission increased significantly (80%) from $45,850 in 2003 to $82,800 in 2010. The inhospital mortality and complication rate was 3.5% and 2.9%, respectively. Factors affecting in-hospital mortality rate were age (≤18 yr vs. >18 yr, P<0.001), insurance type (medicare vs. private insurance, P<0.001), co-morbidities (high vs. low, P<0.001), hospital volume (high vs. low volume, P<0.001), physician's case volumes (high vs. low volume, P<0.02), hospital type (teaching vs. non-teaching, P<0.01) and hospital region (South vs. others, P<0.02). Similarly, factors affecting adverse outcome at discharge were age (≤18 yr vs. >18 yr, P<0.001), female gender (P<0.001), median income (fourth quartile vs. other, P<0.001), ethnicity (African-American vs. non-African-American, P<0.02), insurance type (medicare vs. private insurance, P<0.001), co-morbidities (high vs. low, P<0.001), hospital case volume (4th quartile volume vs. other, P<0.001), physician's case volume (4th quartile volume vs. other, P<0.0001), hospital type (teaching vs. non-teaching, hospital bed size (small vs. large, P<0.001), hospital region (Northeast vs. others, P<0.001) and hospital location (urban vs. rural, P<0.001). CONCLUSION:Nationally, there has been no significant change in the frequency of EDH. However, its cost is increasing rapidly.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Bir SC,Maiti TK,Ambekar S,Nanda Adoi
10.1016/j.clineuro.2015.07.021subject
Has Abstractpub_date
2015-11-01 00:00:00pages
99-103eissn
0303-8467issn
1872-6968pii
S0303-8467(15)00286-3journal_volume
138pub_type
杂志文章abstract::Progressive supranuclear palsy is a heterogeneous system degeneration. We studied three patients by means of electrooculography. There were severe disturbances in saccadic and smooth pursuit eye movements, and optokinetic nystagmus in both vertical and horizontal planes. Caloric reactions were absent in all patients. ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(87)90181-8
更新日期:1987-01-01 00:00:00
abstract::One segment of a large Dutch pedigree with heredo-ataxia is presented. The clinical and genetic features of the disease, together with the M.R.I. findings, indicate the diagnosis of autosomal dominant late onset olivo-ponto-cerebellar atrophy. The clinical picture remained invariant through successive generations. Emp...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(91)90091-3
更新日期:1991-01-01 00:00:00
abstract::The clinical features and additional investigations of 20 Dutch patients suffering from cerebrotendinous xanthomatosis (CTX), an inborn error of metabolism in bile acid synthesis, are described. The onset was in the second or third decade. The clinical picture at the time of examination consisted of a combination of t...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(87)80050-1
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abstract::Localizing the semiology of ictal fear and seizure onset in epilepsy patients is commonly challenging due to limited value of routine electroencephalography (EEG) and very few surgical attempts. Here we reported a case of refractory epilepsy characterized by aura of extreme fear and hypermotor seizures, in which the l...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2017.10.025
更新日期:2017-12-01 00:00:00
abstract::A patient is presented who developed a frontal intracerebral hemorrhage, which proved to be due to a metastasis of a choriocarcinoma. The patient's uterus and adnexa had been removed two years previously for a non-malignant disorder. two years previously for a non-malignant disorder. The authors stress the importance ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(85)90137-4
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVES:Spinal intramedullary tuberculosis is a rare disease. This study aims to acquaint readers with its clinicoradiological features and emphasizes the importance of early treatment in intramedullary spinal tuberculosis. MATERIALS AND METHODS:Retrospective analysis was conducted from 1985 to 2006 over a period o...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.09.029
更新日期:2009-02-01 00:00:00
abstract::We studied 200 female patients with multiple sclerosis (MS) to investigate whether pregnancy after the onset of disease influences long term disability. As an index of progression, we used the time between disease onset and wheelchair dependence. Patients who had at least one pregnancy after onset were wheelchair depe...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(94)90027-2
更新日期:1994-02-01 00:00:00
abstract::Lafora disease (LD) is an autosomal recessive inherited form of progressive myoclonic epilepsy with dementia and ataxia, usually presenting in the second decade of life and inexorably progressing until death. Neuropathological hallmarks are Lafora bodies, intracytoplasmic inclusions that can be found in neurons and in...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2003.07.003
更新日期:2003-12-01 00:00:00
abstract::Ipilimumab is an immunomodulating drug for use in treatment of unresectable or metastatic melanoma with autoimmune lymphocytic hypophysitis as a reported complication. We describe three recent cases of ipilimumab associated autoimmune hypophysitis (IAH) at our institution, and provide a selected literature review show...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2014.06.011
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:The authors investigated the feasibility of a transforaminal endoscopic decompression and un-instrumented lumbar interbody fusion procedures with cancellous bone allograft in patients painful with end-stage degenerative vacuum disc disease. PATIENTS & METHODS:Twenty-nine patients who underwent endoscopic tra...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106002
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:We report the case of a 43-year-old patient with neuralgic shoulder amyotrophy who developed abducens palsy on the left 4 days after diagnostic lumbar puncture (LP), which recovered completely within 4 months. RESULTS:Side effects after spinal tap are due to prolonged spinal fluid leakage and delayed closure...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(01)00170-6
更新日期:2002-01-01 00:00:00
abstract::Amongst the protean extra-intestinal manifestations of inflammatory bowel disease, scant mention is made of muscle involvement. This report outlines the clinical features, electrodiagnostic and muscle biopsy findings in a patient with ulcerative colitis who developed progressive proximal muscle weakness. The demonstra...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(87)80026-4
更新日期:1987-01-01 00:00:00
abstract::Among posterior fossa tumors, schwannomas arising from glossopharyngeal nerve are rare; only about 30 cases of glossopharyngeal neuroma have been described. Though a typical 'jugular foramen syndrome' has been described for tumors of this region, the clinical onset may often closely resemble that of acoustic neuromas ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00016-4
更新日期:1997-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106409
更新日期:2021-01-01 00:00:00
abstract::Behcet's disease (BD) is a rare condition, more commonly seen in Turkey, the Middle East, the Mediterranean, and the Far Eastern countries. It is a multifaced disease involving the central nervous system (CNS), skin, joints, intestines and blood vessels. CNS involvement occurs in 10-25% of the patients with BD. We rep...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2004.07.002
更新日期:2005-06-01 00:00:00
abstract::The frequency of positive results of four conventional provocative tests (Phalen sign, Tinel sign, wrist extension and pressure provocation test) was evaluated in 179 patients with clinical and electrophysiological findings consistent with idiopathic carpal tunnel syndrome (CTS), 147 control subjects and 39 patients w...
journal_title:Clinical neurology and neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0303-8467(01)00140-8
更新日期:2001-10-01 00:00:00
abstract::An 18-year-old male with Maroteaux-Lamy syndrome was presented with spastic quadriparesis. Magnetic resonance imaging of whole spinal canal revealed stenosis at multiple levels of cervical, thoracic and lumbar regions. By the guidance of combined evaluations of neurological examination, neuroradiological and electroph...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2004.05.003
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:There is clinical and experimental evidence involving the insula in the control of the autonomic system and cardiac function, with differential participation of right and left brain hemispheres, and these differences could influence mortality in the acute phase of brain hemisphere ischemic infarcts. METHODS...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2005.10.002
更新日期:2006-10-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2014.01.005
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106419
更新日期:2020-12-08 00:00:00
abstract:OBJECTIVE:Intramedullary spinal cord astrocytomas are uncommon but important entities. Aggressive surgical resection is believed to be critical to prevent subsequent neurological deterioration; however, the prognostic significance of numerous patient and molecular variables remains unclear. We sought to investigate the...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2016.03.009
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2016.07.018
更新日期:2016-09-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.04.013
更新日期:2008-09-01 00:00:00
abstract:AIM:The laboratory diagnosis of pulmonary tuberculosis (TB) and tuberculous meningitis (TBM) is particularly challenging. The aim of the present work is to develop an immunoassay for the diagnosis of TB infection, using synthetic peptides of antigen (Ag) 85 complex of M. tuberculosis (Mtb) H37Rv. METHODS:Four peptides...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.07.031
更新日期:2013-06-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.06.003
更新日期:2013-10-01 00:00:00
abstract::True and false positive rates of auditory and visual evoked potentials, as well as multi-modal evoked potentials, were assessed in groups of 30 multiple sclerosis patients and 19 healthy age-matched subjects. Sensitivity (true positive rate) generally proved to be high confirming published reports. False positive rate...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(92)90058-b
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:This study was conducted to validate the accuracy of image-based pre-operative segmentation using the gold standard endoscopic and microscopic findings for localization and pre-operative diagnosis of the offensive vessel. PATIENTS AND METHODS:Fourteen TN and 6 HS cases were randomly selected. All patients h...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2015.10.006
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.clineuro.2011.09.004
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Surgery for medically resistant epilepsy is safe and effective. However, when noninvasive techniques are insufficient, then consideration is given to invasive electrocorticography (EcoG). OBJECTIVE:The aim of the study was to analyze results and complications of subdural electrodes placement in the treatmen...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.10.007
更新日期:2013-07-01 00:00:00
abstract::Symptomatic spontaneous intratumoral hemorrhage is a rare event in a patient with a brain tumor (BT). Although the treatment of choice in such a case is surgical removal of both the tumor and the hemorrhage, the optimal timing for surgical intervention has not been clearly established, particularly in those who presen...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2004.12.023
更新日期:2005-12-01 00:00:00