Author/Authors :
Ashuntantang, GE University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Internal Medicine Specialties, Cameroon , Kaze, F University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Internal Medicine Specialties, Cameroon , Halle, MP University of Douala - Faculty of Medicine Pharmaceutical Sciences - Department of Clinical Sciences, Cameroon , Menanga, AP University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Internal Medicine Specialties, Cameroon , Tatah, G University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Internal Medicine Specialties, Cameroon , Ze Minkande, J University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Surgery Specialties, Cameroon , Njamnshi, AK University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Internal Medicine Specialties, Cameroon , Eyenga, VC University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Department of Surgery Specialties, Cameroon
Abstract :
INTRODUCTION: Non-traumatic subdural hematoma (SDH) is a rare but grave complication of maintenance hemodialysis (HD), with recent data suggesting a doubling of the annual incidence rate in the USA. With geographic variations in the clinical profile of the ESRD population, we sought to study the pattern of non-traumatic SDH in a Sub-Saharan African hemodialysis setting. METHODOLOGY We conducted a retrospective review of medical records of patients treated by maintenance hemodialysis diagnosed by brain CT scan at the Hemodialysis unit of the Yaoundé General Hospital from November 2002 to November 2012 to identify patients with non-traumatic subdural hematoma occurring after a period of at least 3 months on maintenance HD. Relevant data were collected for analysis. RESULTS A total of two cases of non-traumatic SDH were identified from the 464 patient records (cumulative incidence of 0.43% in 10 years). These were males with end stage renal disease from malignant nephrosclerosis. The mean age was 52 years. None was receiving prophylactic anti-thrombotic agents. Headaches and neurological deficits were the main clinical features. Treatment was surgical with a mortality rate of. Large interdialytic weight gain, excessive ultrafiltrates and uncontrolled hypertension were common findings. CONCLUSION The frequency, clinical presentation, and prognosis of non-traumatic SDH in this study, is consistent with recent reports from Europe and the USA. However, contrary to the latter, non- traumatic SDH occurred in young males without prophylactic antithrombotic agents. Early diagnosis through a high index of suspicion and increased access to brain CT scan may reduce diagnostic delays and improve outcome.
NaturalLanguageKeyword :
Non , traumatic subdural hematoma , maintenance hemodialysis , management , outcome
