INSTRUCTIONS Chronic subdural hematoma: A common complexity
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Chronic subdural hematoma: A common complexity
GENERAL PURPOSE: To provide information about cSDH in adults. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Outline the risk factors for cSDH. 2. Identify nursing interventions for patients with cSDH.
- Which statement about cSDH in adults is true?
- It usually has a very good prognosis.
- It can occur spontaneously.
- It typically develops within 24 hours of the inciting event.
- The incidence of SDH
- is highest in young adults.
- declines in people over age 80.
- almost doubles from ages 65 to 75.
- By 2030, cSDH in the United States is projected to
- affect 15% of the population over age 65.
- affect more older women than men.
- become the most common neurosurgical condition.
- Which statement about cSDH is correct?
- About 83% of patients have a history of minor head trauma.
- It's frequently caused by a fall.
- It's unrelated to brain pathology.
- Most patients with cSDH
- may have an intrinsic susceptibility to developing SDH.
- experienced head trauma with loss of consciousness.
- can identify a specific recent head trauma.
- Which statement about nontraumatic cSDH is correct?
- Compared with traumatic cSDH, it's less likely to result in death.
- Seventy-five percent of patients are taking anticoagulant or antiplatelet therapy.
- Patients on oral anticoagulant therapy have a twofold increased risk for cSDH.
- Which of the following is a risk factor for additional intracerebral hemorrhage?
- undiagnosed atrial fibrillation
- loss of consciousness
- The initial diagnostic imaging study for cSDH is
- contrast CT.
- noncontrast CT.
- The vascular membrane encapsulating a cSDH
- contains friable vessels that may bleed.
- prevents the cSDH from expanding further.
- causes rapid arterial bleeding.
- Which initial intervention is crucial to preventing SDH expansion?
- collaboration between neurologists and neurosurgeons
- monitoring ICP
- normalizing coagulation status
- For patients taking NOACs,
- reversal isn't necessary before emergency surgery.
- nonemergency surgery should be delayed until 24 hours after the last dose.
- anticoagulant reversal therapy includes dabigatran.
- What preoperative intervention is recommended for symptomatic patients taking clopidogrel?
- idarucizumab administration
- platelet transfusion
- delaying surgery for 48 hours
- Which statement is accurate regarding surgical treatment for patients with cSDH?
- Only radiologic imaging can determine the need for evacuation.
- Most cSDHs are naturally reabsorbed without surgical intervention.
- All symptomatic patients should be considered potential surgical candidates.
- Which surgical technique is preferred for an older adult with multiple comorbidities?
- twist drill craniostomy
- burr hole craniostomy
- open craniotomy
- Which statement about SDH recurrence is correct?
- It usually occurs within the first year after the primary event.
- Risk decreases with exposure to statins.
- Recurrence rates are greater than 50%.
- Medical management of cSDH
- is driven by evidence-based guidelines.
- may be complicated by cerebral edema.
- usually results in worsening cSDH within 90 days.
- Compared with traumatic cSDH, the risk of poor outcomes such as readmission for nontraumatic cSDH is
- Which I.V. fluids are administered to support cerebral perfusion in patients with cSDH?