1
|
Kehayov I, Davarski A, Angelova P, Kitov B. Sacral nerve root metastasis in a patient with lung carcinoma resembling neurinoma - a case report and literature review. Folia Med (Plovdiv) 2024; 66:136-141. [PMID: 38426477 DOI: 10.3897/folmed.66.e111619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/10/2023] [Indexed: 03/02/2024] Open
Abstract
Intradural extramedullary metastases from systemic neoplasms are very rare, with an incidence ranging from 2% to 5% of all secondary spinal diseases. We present the case of a 53-year-old man diagnosed with lung adenocarcinoma with symptoms of severe back pain and tibial paresis. The magnetic resonance imaging (MRI) revealed an intradural lesion originating from the right S1 nerve root mimicking neurinoma. Total tumor removal was achieved via posterior midline approach. The histological examination was consistent with lung carcinoma metastasis. Due to the rarity of single nodular nerve root metastases, MRI images may be misinterpreted as nerve sheath tumors, such as schwannomas or neurofibromas. We performed a brief literature review outlining the mainstay of diagnosis, therapeutic approach, and the prognosis of these rare lesions.
Collapse
Affiliation(s)
- Ivo Kehayov
- Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | | | | |
Collapse
|
2
|
Kitov B, Davarski A, Angelova P, Kitova T, Kehayov I. 'Vertebral osteomyelitis after spine instrumentation surgery: risk factors and management' by E. Benavent et al., J Hosp Infect 2023;140:102-9. J Hosp Infect 2023; 142:142-143. [PMID: 37690485 DOI: 10.1016/j.jhin.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Affiliation(s)
- B Kitov
- Clinic of Neurosurgery, Saint Georgi University Hospital, Plovdiv, Bulgaria
| | - A Davarski
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - P Angelova
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - T Kitova
- Department of Anatomy, Histology and Embryology, Medical Faculty, Medical University of Plovdiv, Bulgaria
| | - I Kehayov
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
3
|
Kitov B, Davarski A, Kitova T, Angelova P, Kehayov I. Letter to Editor Regarding "Management of Lumbar Pyogenic Spondylodiscitis in Germany: A Cross-Sectional Analysis of Spine Specialists". World Neurosurg 2023; 179:250. [PMID: 38078393 DOI: 10.1016/j.wneu.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 12/18/2023]
Affiliation(s)
- Borislav Kitov
- Clinic of Neurosurgery, Sv. Georgi University Hospital, Plovdiv, Bulgaria
| | - Atanas Davarski
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Tanya Kitova
- Department of Anatomy, Histology and Embryology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Polina Angelova
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Ivo Kehayov
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
4
|
Kitov B, Kehayov I, Davarski A, Kitova T. Letter to the Editor: Does Operative Management of Epidural Abscesses Increase Healthcare Expenditures up to 1 Year After Treatment? Clin Orthop Relat Res 2023; 481:1858-1859. [PMID: 37466440 PMCID: PMC10427034 DOI: 10.1097/corr.0000000000002789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023]
Affiliation(s)
- Borislav Kitov
- Professor, Clinic of Neurosurgery, St. George University Hospital, Plovdiv, Bulgaria
| | - Ivo Kehayov
- Associate Professor, Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Atanas Davarski
- Assistant Professor, Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Tanya Kitova
- Professor, Department of Anatomy, Histology and Embryology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
5
|
Angelova P, Kitov B, Davarski A, Kitova T, Kehayov I. Short-term outcome of treatment of elderly patients with epidural hematomas. Folia Med (Plovdiv) 2023; 65:371-377. [PMID: 38351811 DOI: 10.3897/folmed.65.e82210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/30/2022] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION There is substantial literature data dedicated to intracranial epidural hematomas affecting young and middle-aged individuals, but studies focusing on their characteristics in elderly patients are scarce, assuming that old age is a poor prognostic factor.
Collapse
Affiliation(s)
| | | | | | - Tanya Kitova
- Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ivo Kehayov
- Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
6
|
Kitov B, Milkov D, Davarski A. Letter to Editor Regarding: "Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus Constellatus Leads to Paraplegia in an Adult: A Case Report" [Letter]. Infect Drug Resist 2023; 16:3999-4000. [PMID: 37366499 PMCID: PMC10290850 DOI: 10.2147/idr.s425018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
- Borislav Kitov
- Clinic of Neurosurgery, University Hospital St. George, Plovdiv, Bulgaria
| | - Denis Milkov
- Clinic of Otolaryngology, University Hospital Kaspela, Plovdiv, Bulgaria
| | - Atanas Davarski
- Department of Neurosurgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
7
|
Kehayov I, Uchikov P, Davarski A, Kitov B. Letter to the Editor concerning "Evaluation of the relevance of surgery in a retrospective case series of patients who underwent the surgical treatment of a symptomatic spine metastasis from lung cancer" by Zairi F et al. (Eur Spine J [2016]; doi: 10.1007/s00586-016-4397-4). Eur Spine J 2023; 32:389-390. [PMID: 36436086 DOI: 10.1007/s00586-022-07474-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 06/12/2022] [Accepted: 11/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Ivo Kehayov
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd, 4000, Plovdiv, Bulgaria.
| | - Petar Uchikov
- Department of Special Surgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Atanas Davarski
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd, 4000, Plovdiv, Bulgaria
| | - Borislav Kitov
- Clinic of Neurosurgery, Sv. Georgi University Hospital, Plovdiv, Bulgaria
| |
Collapse
|
8
|
Kitov B, Davarski A, Angelova P, Kehayov I. Letter to Editor Regarding : "The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery". J Korean Neurosurg Soc 2023; 67:133-134. [PMID: 37407068 PMCID: PMC10788553 DOI: 10.3340/jkns.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 07/03/2023] [Indexed: 07/07/2023] Open
Affiliation(s)
- Borislav Kitov
- Clinic of Neurosurgery, Sveti Georgi University Hospital, Plovdiv, Bulgaria
| | - Atanas Davarski
- Department of Neurosurgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Polina Angelova
- Department of Neurosurgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ivo Kehayov
- Department of Neurosurgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
9
|
Kitov B, Apostolov G, Davarski A, Kehayov I, Kilova K. Analysis of characteristics and surgical outcome of intradural extramedullary tumors - a retrospective cohort study of 52 patients. Folia Med (Plovdiv) 2022; 64:609-616. [PMID: 36045456 DOI: 10.3897/folmed.64.e64273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/18/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Although intradural extramedullary tumors (IET) are relatively well studied, research on the typical epidemiological, demographic, and clinical characteristics of these malignancies is scanty. AIM The aim of this study was to investigate retrospectively the epidemiology, demographics, clinical presentation, imaging data, type of surgery, and the outcome of treatment of IETs. MATERIALS AND METHODS We performed retrospective chart review of medical history, clinical presentation, paraclinical and imaging data, and operative protocols of operated patients with IETs from January 2011 to August 2020. Special attention was paid to the onset of symptoms, clinical presentation at admission, imaging data, localization, type of surgery, histology, and outcome of the disease. The degree of neurological deficit and disability of the patients at admission, discharge, and follow-up was assessed by the Modified McCormick Scale and the Modified Rankin Scale, respectively. The follow-up period varied from 1 to 105 months (mean 43 months). RESULTS Fifty-two patients (mean age 58 years, range 14-78 years) with IETs were surgically treated for the study period. At admission to the clinic, 48 patients (92.3%) had vertebralgia, 34 (65.4%) had concurrent radicular pain, 42 (80.8%) had motor deficit, and 18 (34.6%) had sphincter disorders. Total tumor removal was achieved in 47 patients (90.4%). Favourable outcome was registered in 43 patients (82.7%). The degree of disability (mRS) at admission (p=0.0001), the McCormick grade at admission (p=0.0001), gender (p=0.042), and age (p=0.047) of patients were significantly correlated with the functional status assessed by McCormick scale at discharge. CONCLUSIONS Most of the IETs can be successfully removed via a standard posterior or posterolateral surgical access. Favourable outcome of treatment depends on early diagnosis and total tumor resection.
Collapse
Affiliation(s)
| | | | | | - Ivo Kehayov
- Medical University of Plovdiv, Plovdiv, Bulgaria
| | | |
Collapse
|
10
|
Kitov B, Kitova T, Davarski A, Kehayov I. Letter to the Editor Regarding "Telemedicine in Neurosurgery During the COVID-19 Outbreak: Where We Are 1 Year Later". World Neurosurg 2022; 163:149. [PMID: 35729813 DOI: 10.1016/j.wneu.2022.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Borislav Kitov
- Clinic of Neurosurgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Tanya Kitova
- Department of Anatomy, Histology and Embryology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Atanas Davarski
- Clinic of Neurosurgery, University Hospital "St. George", Plovdiv, Bulgaria
| | - Ivo Kehayov
- Department of Neurosurgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
11
|
Davarski A, Kitov B, Apostolov G, Kehayov I, Stoyanova R. Correlations between preoperative clinical factors and treatment outcome of spinal meningiomas - A retrospective study of a series of 31 cases. Surg Neurol Int 2021; 12:236. [PMID: 34221567 PMCID: PMC8248145 DOI: 10.25259/sni_927_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 04/23/2021] [Indexed: 12/01/2022] Open
Abstract
Background: The purpose of the current study is to identify the correlations between the most important preoperative clinical factors and the outcome of surgery of spinal meningiomas (SM). Methods: We performed a retrospective analysis of the medical history, clinical, paraclinical, neuroimaging, and surgical protocol data in 31 patients with SM who underwent surgical resection at our institution from January 2011 to July 2020. The degree of resection was assessed on the Simpson scale. The modified McCormick scale was used to monitor the effect and outcome of treatment at admission, discharge, and at further follow-up. Results: The average age of the patients was 65 years (37-78). Vertebral pain and motor deficits were the most common initial symptoms that occurred in 26 (89.6%) and 29 (93.5%) patients, respectively. Sphincter disorders were found in 9 (29%) patients. Total resection (Simpson Grade I – II) was achieved in 29 patients (93.5%). We achieved a favorable outcome (McCormick Gr. I to III) in 93.3% of patients. The degree of the neurological deficit (P = 0.026) and the presence of sphincter disorders (P = 0.009) were the preoperative clinical factors that most significantly correlated with the outcome of treatment. Conclusion: The outcome from the surgical treatment of SM correlated significantly with the degree of the preoperative neurological deficit. Therefore, patients presenting with more severe symptoms are expected to have worse outcomes.
Collapse
Affiliation(s)
- Atanas Davarski
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Borislav Kitov
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Georgi Apostolov
- Clinic of Neurosurgery, Sv. Georgi University Hospital, Plovdiv, Bulgaria
| | - Ivo Kehayov
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Rumyana Stoyanova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
12
|
Angelova P, Kehayov I, Davarski A, Kitov B. Contemporary insight into diffuse axonal injury. Folia Med (Plovdiv) 2021; 63:163-170. [PMID: 33932004 DOI: 10.3897/folmed.63.e53709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 11/12/2022] Open
Abstract
Diffuse axonal injury (DAI) is present in approximately 50% of the cases with severe traumatic brain injury. It is one of the leading causes of morbidity and mortality among children and young individuals worldwide. Generally, DAI occurs as a result of high-velocity accidents. Typically, it presents with loss of consciousness for at least 6 hours and neurological deficit dependent on the brain area that is affected by the injury. The final diagnosis is confirmed by neuroimaging studies such as computed tomography and magnetic resonance imaging. According to the injured brain site, DAI is classified into three grades: Grade I-DAI with axonal lesions in the cerebral hemispheres; Grade II-DAI with focal axonal lesions in the corpus callosum; Grade III-DAI with focal or multiple axonal lesions in the brainstem. Each of the three grades is associated with different outcome.Due to the high disability and mortality rate, DAI represents an important medical, personal and social problem. The aim of the current review is to address the unsolved issues connected with the pathogenesis, diagnostics, treatment and outcome of the diffuse axonal injury.
Collapse
Affiliation(s)
| | - Ivo Kehayov
- Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | | |
Collapse
|
13
|
Kitov B, Kehayov I, Davarski A, Stoyanova R. Outcome of Surgical Treatment of Spontaneous Spinal Epidural Abscesses for a 10-year Period. Folia Med (Plovdiv) 2020; 62:482-489. [PMID: 33009757 DOI: 10.3897/folmed.62.e49902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/15/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Spinal epidural abscess is uncommon but potentially debilitating infection. Delay in early diagnosis may be associated with increased morbidity and mortality despite recent advances in medicine. AIM To present the clinical course and outcome of treatment of spontaneous spinal epidural abscesses. MATERIALS AND METHODS Thirty-four patients (20 men and 14 women) with clinical, neuroimaging and/or histological data for spinal epidural abscess were treated at the Clinic of Neurosurgery at St George University Hospital, Plovdiv, Bulgaria, for the period 2009-2018. RESULTS The average age of patients was 62 years (21-76 years) and the ratio of men to women was 1.4:1. All patients (100%) presented with vertebralgia, 13 patients (38.2%) had additional radiculalgia, and 10 patients (29.4%) presented with sensory or motor deficit. The duration of complaints varied from 4 to 180 days. At hospital admission, only 9 patients (26.4%) had intact neurological status. The most common localization of the spinal epidural abscess was in the lumbar and lumbosacral area (52.9%), concomitant spondylodiscitis was present in 31 patients (91.2%). Twenty-four patients (70.6%) underwent emergency surgery within 24 hours, and the rest had planned surgery. Decompressive interlaminotomy or hemilaminectomy was performed in 9 patients (26.5%). The remaining 25 patients (73.5%) underwent laminectomy, in 15 patients (44.1%) it was combined with posterior pedicle screw fixation. After the treatment, 23 patients (67.6%) had a good outcome, the remaining 11 (32.4%) had a poor outcome, and 3 patients died (8.8%). CONCLUSION In patients with spinal epidural abscess, emergency surgery is the treatment method of choice. It allows decompression of neural structures, correction of the spinal deformity, segmental stabilization and rapid mobilization of patients.
Collapse
Affiliation(s)
| | - Ivo Kehayov
- Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | | |
Collapse
|
14
|
Dzhambazov K, Kehayov I, Topalova A, Kitov B, Zhelyazkov H, Davarski A. Endoscopic endonasal resection of congenital trans-sphenoidal meningoencephalocele with extension to the epipharynx in early childhood: a case report. Afr Health Sci 2019; 19:2764-2767. [PMID: 32127849 PMCID: PMC7040274 DOI: 10.4314/ahs.v19i3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The clinical presentation of sphenoid sinus meningoencephaloceles (MEC) may have insidious onset and evolution. Contemporary treatment incorporates endoscopic resection via the endonasal route. Case description We present a case of 3 year old girl who had been complaining of permanent nasal discharge, impeded nasal breathing and difficulty with feeding since she was 5 months old. There was no history of rhinoliquorrhea. Pre-operative magnetic resonance imaging demonstrated MEC that extended from the sellar region through the non-pneumatized sphenoid sinus to the nasopharynx. The lesion was resected via endoscopic endonasal approach. Follow-up rhinoscopy confirmed the absence of post-operative cerebrospinal fluid leak. Conclusion Endoscopic endonasal approach can be an effective and a safe treatment option for resection of congenital transsphenoidal MEC in early childhood.
Collapse
Affiliation(s)
- Karen Dzhambazov
- Department of Ear, Nose and Throat Diseases, Faculty of Medicine, Medical University-Plovdiv, Bulgaria
| | - Ivo Kehayov
- Department of Neurosurgery, Faculty of Medicine, Medical University-Plovdiv, Bulgaria
| | - Alexandrina Topalova
- Department of Ear, Nose and Throat Diseases, Faculty of Medicine, Medical University-Plovdiv, Bulgaria
| | - Borislav Kitov
- Department of Neurosurgery, Faculty of Medicine, Medical University-Plovdiv, Bulgaria
| | - Hristo Zhelyazkov
- Department of Neurosurgery, Faculty of Medicine, Medical University-Plovdiv, Bulgaria
| | - Atanas Davarski
- Department of Neurosurgery, Faculty of Medicine, Medical University-Plovdiv, Bulgaria
| |
Collapse
|
15
|
Kehayov I, Kostic A, Kitov B, Nikolov V, Zhelyazkov H, Davarski A. The impact of age, gender, acuteness and etiology on short-term clinical outcome in patients with subdural hematomas - international dual-center study. SRP ARK CELOK LEK 2018. [DOI: 10.2298/sarh171016024k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Objective. Subdural hematoma is one of the most common intracranial types of bleeding with high risk of disability and mortality. The aim of this study was to determine the influence of age, sex, acuteness, and etiology of subdural hematoma on short-term clinical outcome in these patients. Methods. We retrospectively studied 288 patients who were diagnosed and operated on for subdural hematomas (SDH) with different etiology (traumatic and spontaneous) and acuteness (acute, subacute, and chronic) for a period of five years. Patients scored ? 5 points on the Glasgow Coma Scale at hospital admission were not included in this study. Clinical outcome was assessed by the modified Rankin Scale (mRS) score at hospital discharge. Descriptive statistics and logistic regression analysis were used to determine the effect of the investigated factors on short-term clinical outcome. Results. Logistic regression analysis was conducted to predict degree of recovery (good = mRS ?1 vs. poor = mRS ? 2 or death) using sex, age, acuteness, and etiology of SDH as predictive factors. It was established that the following three factors made a significant contribution to the outcome: age (p = 0.004), acuteness (p < 0.001), and etiology of a hematoma (p = 0.023), with acuteness being the strongest predictive factor. Sex was not a significant predictor, while age under 70 years and spontaneous origin of SDH were associated with lower mRS scores and had a positive effect on recovery chances. Conclusion. Age, acuteness, and etiology of hematoma are important predictive factors that influence the short-term clinical outcome in patients with SDH. These parameters should be taken into account when giving prognosis for recovery chances to a patient?s family and relatives.
Collapse
Affiliation(s)
- Ivo Kehayov
- Sveti Georgi University Hospital, Medical University in Plovdiv, Clinic of Neurosurgery, Department of Neurosurgery, Plovdiv, Bulgaria
| | | | - Borislav Kitov
- Sveti Georgi University Hospital, Medical University in Plovdiv, Clinic of Neurosurgery, Department of Neurosurgery, Plovdiv, Bulgaria
| | - Vesna Nikolov
- Clinical Center of Niš, Clinic for Neurosurgery, Niš
| | - Hristo Zhelyazkov
- Sveti Georgi University Hospital, Medical University in Plovdiv, Clinic of Neurosurgery, Department of Neurosurgery, Plovdiv, Bulgaria
| | - Atanas Davarski
- Sveti Georgi University Hospital, Medical University in Plovdiv, Clinic of Neurosurgery, Department of Neurosurgery, Plovdiv, Bulgaria
| |
Collapse
|
16
|
Zhelyazkov C, Davarski A, Kitova T, Kehayov I, Kitov B. Tandem compression of medulla spinalis and cauda equina. SANAMED 2015. [DOI: 10.5937/sanamed1501065z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
|
17
|
Koev I, Simitchiev K, Zhelyazkov H, Kitov B, Kalnev B, Davarski A. Analysis of Prognostic Factors in Adult Patients with Glioblastoma Multiforme. J Neurol Surg A Cent Eur Neurosurg 2014. [DOI: 10.1055/s-0034-1382234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|