The 2nd edition of The holistic Prevention, Management and Treatment of Dementia under The Microscope of Conventional Medicine: Treatments of Subdural hematoma

Kyle J. Norton (Scholar)

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Abstract
Dementia is defined as neuro degeneration syndrome among elder, affecting memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement over 47 millions
of worldwide population, mostly in the West. The evaluation of the syndrome by holistic medicine has been lacking, especially through conventional medicine research and studies. The aim of this essay is to provide accurate information of how effective of holistic medicine in prevention, management and treatment of dementia through searching data base of PubMed.
This is the third time, a research paper has been written this way to general public that you will not find any where in the net.

Dementia is a neuropsychiatric disorder induced of cognitive impairment and behavioral disturbances. The behavioral and psychological symptoms of dementia (BPSD) are common, with a progressive loss of memory and other mental abilities, affecting a person's ability to perform usual tasks in everyday life.

F. 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 unfavourable 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
In 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-brainbarrier 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 DentalUniversity 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 subduralhaematoma 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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(549)Acute Subdural Hematoma. Author: Alex Koyfman, MD; Chief Editor: Rick Kulkarni, MD more(Medscape))..
(550)[Analysis of prognostic factors for patients with traumatic acute subdural hematomas treated by surgery].[Article in Chinese]by Song C1, Ren X1, Zhao B1, Fu H1, Lin S2, Zhang Y1.(PubMed)
(551) Management and outcome of patients with acute traumatic subdural hematomas and pre-injury oral anticoagulation therapy by Senft C1, Schuster T, Forster MT, Seifert V, Gerlach R.(PubMed)
(552) Case report: treatment of subdural hematoma in the emergency department utilizing the Subdural Evacuating Port System by Asfora WT, Klapper HB.(PubMed)
(553) Subdural Hematoma Treatment & Management. Author: Richard J Meagher, MD; Chief Editor: Helmi L Lutsep, MD more..(Medscape)
(554) Chronic subdural hematoma. Surgery or mannitol treatment by Gjerris F, Schmidt K.(PubMed)
(555) Mannitol in acute traumatic brain injury by Schrot RJ1, Muizelaar JP.(PubMed)
(556) Effect of neuroprotective N-methyl-D-aspartate antagonists on increased intracranial pressure: studies in the rat acute subdural hematoma model by Kuroda Y1, Fujisawa H, Strebel S, Graham DI, Bullock R.(PubMed)
(557) Methylprednisolone(Wikipedia)
(558) Effects of intracarotid injection of methylprednisolone on cellular oedema after osmotic opening of the blood-brain barrier in rats by Kozler P1, Pokorný J.(PubMed)
(559)
(560) Anticonvulsants for preventing seizures in patients with chronic subdural haematoma. by Ratilal BO1, Pappamikail L, Costa J, Sampaio C.(PubMed)
(561) Low incidence of seizures in patients with chronic subdural haematoma. by Ohno K1, Maehara T, Ichimura K, Suzuki R, Hirakawa K, Monma S.(PubMed)
(562) Epilepsy in chronic subdural haematoma by Rubin G1, Rappaport ZH.(PubMed)
(563) Rifampicin(Wikipedia)
(564) Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial by Santarius T1, Kirkpatrick PJ, Ganesan D, Chia HL, Jalloh I, Smielewski P, Richards HK, Marcus H, Parker RA, Price SJ, Kirollos RW, Pickard JD, Hutchinson PJ(PubMed)
(565) Acute subdural hemorrhage associated with rifampicin-induced thrombocytopenia. by Kang SY1, Choi JC, Kang JH, Lee JS.(PubMed)
(566) A case of acute and severe thrombocytopenia due to readministration of rifampicin by Mori M1, Izawa K, Fujikawa T, Uenami T, Sugano T, Kagami S, Namba Y, Yano Y, Yoneda T, Kitada S, Kimura H, Yamaguchi T, Yokota S, Maekura R.(PubMed)
(567) An Unreported Clindamycin Adverse Reaction: Wrist Monoarthritis(IJPR)
(568) Craniotomy(Wikipedia)
(569) Acute subdural hemorrhage associated with rifampicin-induced thrombocytopenia by Kang SY1, Choi JC, Kang JH, Lee JS.(PubMed)
(570) Chronic subdural haematoma treated by craniotomy, durectomy, outer membranectomy and subgaleal suction drainage. Personal experience in 39 patients by Mohamed EE1.(PubMed)