David Yuen Chung Chan1, Wai Sang Poon2, Danny Tat Ming Chan1, Wai Kit Mak1, George Kwok Chu Wong1. 1. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China. 2. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China. wpoon@surgery.cuhk.edu.hk.
Abstract
BACKGROUND: The COVID-19 novel coronavirus is contagious, and the mortality is higher in the elderly population. Lockdown in different parts of the world has been imposed since January 2020. Chronic subdural haematoma (cSDH) has a unique natural history in which symptoms can be non-specific, and the onset is insidious. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation of cSDH. METHODS: Consecutive adult cSDH patients admitted from 1 March 2020 to 30 April 2020 were reviewed. Exclusion criteria including those who had no definite history of head injury or the diagnosis of cSDH were made from a scheduled follow-up scan. Corresponding data during the same period in 2019 were reviewed for comparison. The primary outcome was the interval between the initial head injury and the final radiological diagnosis of cSDH. Secondary outcomes include Markwalder chronic subdural haematoma grade upon admission, length of stay in the acute hospital, and the modified Rankin scale (mRS) upon discharge. RESULTS: For the primary outcome, the average interval between head injury and the diagnosis of cSDH was significantly longer at 56.6 days (49 to 74 days, SD 9.83 days) during the period from March to April 2020, versus 29.4 days (17 to 42 days, SD 8.59 days) in 2019 for the corresponding period (p = 0.00703). There was no significant difference in the functional outcome upon discharge. CONCLUSIONS: cSDH patients can present late during the COVID-19 lockdown period. The functional outcome was comparable when operations for drainage were timely performed.
BACKGROUND: The COVID-19 novel coronavirus is contagious, and the mortality is higher in the elderly population. Lockdown in different parts of the world has been imposed since January 2020. Chronic subdural haematoma (cSDH) has a unique natural history in which symptoms can be non-specific, and the onset is insidious. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation of cSDH. METHODS: Consecutive adult cSDH patients admitted from 1 March 2020 to 30 April 2020 were reviewed. Exclusion criteria including those who had no definite history of head injury or the diagnosis of cSDH were made from a scheduled follow-up scan. Corresponding data during the same period in 2019 were reviewed for comparison. The primary outcome was the interval between the initial head injury and the final radiological diagnosis of cSDH. Secondary outcomes include Markwalder chronic subdural haematoma grade upon admission, length of stay in the acute hospital, and the modified Rankin scale (mRS) upon discharge. RESULTS: For the primary outcome, the average interval between head injury and the diagnosis of cSDH was significantly longer at 56.6 days (49 to 74 days, SD 9.83 days) during the period from March to April 2020, versus 29.4 days (17 to 42 days, SD 8.59 days) in 2019 for the corresponding period (p = 0.00703). There was no significant difference in the functional outcome upon discharge. CONCLUSIONS: cSDH patients can present late during the COVID-19 lockdown period. The functional outcome was comparable when operations for drainage were timely performed.
Entities:
Keywords:
COVID-19; Chronic subdural haematoma; Head injury; Novel coronavirus
Authors: Thomas Santarius; Peter J Kirkpatrick; Dharmendra Ganesan; Hui Ling Chia; Ibrahim Jalloh; Peter Smielewski; Hugh K Richards; Hani Marcus; Richard A Parker; Stephen J Price; Ramez W Kirollos; John D Pickard; Peter J Hutchinson Journal: Lancet Date: 2009-09-26 Impact factor: 79.321
Authors: David Yuen Chung Chan; Danny Tat Ming Chan; Wai Kit Mak; George Kwok Chu Wong; Wai Sang Poon Journal: Neurosurgery Date: 2020-08-01 Impact factor: 4.654
Authors: David Yuen Chung Chan; Eric Yuk Hong Cheung; Ka Ho Hui; Cecelia Mei Sze Leung; Stephanie Chi Ping Ng; Wai Kit Mak; George Kwok Chu Wong; Tat Ming Danny Chan; Wai Sang Poon Journal: Chin Neurosurg J Date: 2022-08-03