Evidence map›Paper›PMID 27591858›Full record

ArticlePituitary2016

Incidence and risk factors of subdural hematoma after intraoperative cerebrospinal fluid leakage during the transsphenoidal approach.

Kazuhito Takeuchi, Tadashi Watanabe, Tetsuya Nagatani, Yuichi Nagata, Jonsu Chu, Toshihiko Wakabayashi

Abstract read
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In one paragraph

Article in Pituitary, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Kazuhito TakeuchiDepartment of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. ktakeuchi@med.nagoya-u.ac.jp.
Tadashi WatanabeDepartment of Neurosurgery, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan.
Tetsuya NagataniDepartment of Neurosurgery, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan.
Yuichi NagataDepartment of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Jonsu ChuDepartment of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Toshihiko WakabayashiDepartment of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Nagoya University · JPJapanese Red Cross Nagoya Daini Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe transsphenoidal approach (TSA) is regarded as the first line of treatment for sellar and suprasellar lesions. There are only few case reports of postoperative subdural hematoma after TSA and extended transsphenoidal approach (eTSA), and the detailed incidence and risk factors for this complication are still unknown. We reviewed the incidence and risk factors for subdural hematoma after TSA and eTSA.

methodsBetween January 1, 2013 and December 31, 2014, 165 consecutive patients underwent TSA or eTSA at Nagoya University Hospital and Nagoya Daini Red Cross Hospital. Fifty-one patients experienced intraoperative CSF leakage. Postoperative subdural hematoma was observed in 10 patients, all of whom experienced intraoperative CSF leakage. We reviewed clinical data including CT and MR images and examined factors related to subdural hematoma among patients with intraoperative CSF leakage.

resultsIn univariate statistical analyses, risk factors for postoperative subdural hematoma were advanced age, high Evans' index, and preoperative hypopituitarism. These factors were also significant in the multivariate logistic regression analysis. There were no statistical differences in sex, tumor size, approach methods, preoperative diabetes insipidus, or degree of intraoperative CSF leakage.

conclusionsThe incidence of postoperative subdural hematoma after intraoperative CSF leakage during TSA and eTSA was higher than the incidence reported in patients after craniotomy. Intraoperative CSF leakage should be avoided as much as possible, especially in patients with brain atrophy and/or enlargement of the ventricular system, even if the intent of the reconstruction technique is authenticity. In addition, patients with hypopituitarism should be carefully followed up after surgery.

Indexed as

AdultAgedCerebrospinal Fluid LeakFemaleHematoma, SubduralHumansIncidenceIntraoperative ComplicationsJapanMagnetic Resonance ImagingMaleMiddle AgedNeurosurgical ProceduresPituitary NeoplasmsPostoperative ComplicationsRetrospective StudiesCerebrospinal fluid leakageCraniopharyngiomaHypopituitarismPituitary adenomaSubdural hematomaTranssphenoidal surgery

Identifiers

PMID27591858
OpenAlexW2508213739

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.