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Saturday, 17 January 2015

(Preview)Most common diseases of 50 plus - Diseases of Central Nervous system(CNS): Dementia - Treatments of Dementia associated with Subdural hematoma

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By Kyle J. Norton Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

About 5-8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. Dementia is the loss of mental ability that is severe enough to interfere with people's every life and Alzheimer's disease is the most common type of dementia in aging people. American typical diet contains high amount of saturated and trans fat, artificial ingredients with less fruits and vegetable which can lead to dementia and other kind of diseases.
VI. Treatments
Depending to the causes of disease, most medication are to control the symptoms

E. Subdural hematoma is the accumulation of blood beneath the outer covering of the brain resulted from the rupture of blood vessel(545)(546). Subdural hemorrhages may cause an increase intracranial pressure(545), which can cause compression of and damage to delicate brain tissue(547). Acute subdural hematoma has a high mortality rate(546). The diseases are most prevalent among elderly individuals(544).

E.2. Treatments of Subdural hematoma
1. Emergency treatment
An acute subdural hematoma (SDH) is a rapidly clotting blood collection(548) below the inner layer of the dura but external to the brain and arachnoid membrane(549). Two further stages, subacute and chronic, may develop with untreated acute subdural hematoma (SDH)(549). There is always important to maintain survival of the patient with acute subdural hematomas(550)(551) because of its an unfavorable outcome in the majority of cases(551). Emergency treatment is necessary to reduce pressure and allow blood to drain by drilling a small hole in the skull and  inserting a temporary small catheter through a hole drilled through the skull and sucking out the hematoma(552)(564).  Although hematoma resolution has been reported, it cannot be reliably predicted, and no medical therapy has been shown to be effective in expediting the resolution of acute or chronic subdural hematomas(552)(553).

2. Medication
Inn case of chronic subdural hematomas, Mannitol may be used to reduce intracranial pressure (ICP)(554)(555) as it produced a significant reduction in ICP and improved cerebral perfusion pressure(556).
a. Corticosteroids for brain oedema
Methylprednisolone is a synthetic glucocorticoid or corticosteroid drug(557). Researchers found that Methylprednisolone can effectively reduce myelin changes(559) accompanying brain oedema(558) induced by blood-brain barrier opening with an osmotic insult(559).

b. Anticonvulsants for patient with seizures
In some cases, patients with chronic subdural haematoma may be treated with anticonvulsants for seizures prevention(560). The medicine has shown to reduce risk of seizures(562) to none and 1.8%  in 73 patients given prophylactic antiepileptic drug treatment in Tokyo Medical and Dental University study(561) and Beilinson Medical Center(562) studies, respectively.

c.  Rifampicin for bacterial infection
Rifampicin is a naturally made, non-peptide antibiotic(563). It is bactericidal, killing agent  by disabling the protein expression system universally conserved by all bacterial infection(567), but it can induce thrombocytopenia(565)(566) in acute subdural hematoma treatment.

3. Surgery
Large or symptomatic hematomas require a craniotomy, as a bone flap is temporarily removed from the skull to access the brain for removal of blood clot with suction or irrigation(568). According University of Cambridge, Cambridge, the use of a drain after burr-hole drainage of chronic subdural haematoma and minimized the incidence of significant recollection(570) is safe and associated with reduced recurrence and mortality at 6 months(569).

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References
(544) http://www.ncbi.nlm.nih.gov/pubmed/25224156
(545) http://www.ncbi.nlm.nih.gov/pubmed/24313607
(546) http://www.ncbi.nlm.nih.gov/pubmed/19139303
(546) http://www.ncbi.nlm.nih.gov/pubmed/25367584
(547) http://www.ncbi.nlm.nih.gov/pubmed/24049555
(548) http://www.ncbi.nlm.nih.gov/pubmed/24784316
(549) http://emedicine.medscape.com/article/828005-overview
(550) http://www.ncbi.nlm.nih.gov/pubmed/25142860
(551) http://www.ncbi.nlm.nih.gov/pubmed/19570326
(552) http://www.ncbi.nlm.nih.gov/pubmed/23066609
(553) http://emedicine.medscape.com/article/1137207-treatment
(554) http://www.ncbi.nlm.nih.gov/pubmed/4817809
(555) http://www.ncbi.nlm.nih.gov/pubmed/12020522
(556) http://www.ncbi.nlm.nih.gov/pubmed/7936130
(557) http://en.wikipedia.org/wiki/Methylprednisolone
(558) http://www.ncbi.nlm.nih.gov/pubmed/15782554
(559) http://www.ncbi.nlm.nih.gov/pubmed/22286794 
(560) http://www.ncbi.nlm.nih.gov/pubmed/23744552
(561) http://www.ncbi.nlm.nih.gov/pubmed/8229039
(562) http://www.ncbi.nlm.nih.gov/pubmed/8213276
(563) http://en.wikipedia.org/wiki/Rifampicin
(564) http://www.ncbi.nlm.nih.gov/pubmed/19782872
(565) http://www.ncbi.nlm.nih.gov/pubmed/19960218
(566) http://www.ncbi.nlm.nih.gov/pubmed/20827562
(567) http://ijpr.sbmu.ac.ir/?_action=articleInfo&article=1112
(568) http://en.wikipedia.org/wiki/Craniotomy
(569) http://www.ncbi.nlm.nih.gov/pubmed/19960218
(570) http://www.ncbi.nlm.nih.gov/pubmed/14565521

Reprinted from Norton Journal, Volume I, Most Common Diseases of Ages of 50 Plus - Chapter of Diseases of Central Nervous system(CNS): Dementia - Treatments by Kyle J. Norton