A pathognomonic sign of leakage of cerebrospinal fluid into the subdural space

1951 ◽  
Vol 26 (11) ◽  
pp. 550-551
Author(s):  
A. A. McConnell
Keyword(s):  
Cerebrospinal Fluid ◽  
Subdural Space ◽  
Pathognomonic Sign

Cerebrospinal fluid leakage into the subdural space: possible influence on the pathogenesis and recurrence frequency of chronic subdural hematoma and subdural hygroma

2008 ◽  
Vol 108 (2) ◽  
pp. 275-280 ◽  
Author(s):  
Rudolf A. Kristof ◽  
Jochen M. Grimm ◽  
Birgit Stoffel-Wagner
Keyword(s):  
Cerebrospinal Fluid ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Postoperative Recurrence ◽  
Cerebrospinal Fluid Leakage ◽  
Subdural Space ◽  
Subdural Hygroma ◽  
Fluid Leakage ◽  
Csf Leakage

Object The purpose of this study was to clarify whether cerebrospinal fluid (CSF) leakage into the subdural space is involved in the genesis of chronic subdural hematoma (CSDH) and subdural hygroma (SH) and to clarify whether this leakage of CSF into the subdural space influences the postoperative recurrence rate of CSDH and SH. Methods In this prospective observational study, 75 cases involving patients treated surgically for CSDH (67 patients) or SH (8 patients) were evaluated with respect to clinical and radiological findings at presentation, the content of β -trace protein (β TP) in the subdural fluid (βTPSF) and serum (βTPSER), and the CSDH/SH recurrence rate. The βTPSF was considered to indicate an admixture of CSF to the subdural fluid if βTPSF/βTPSER > 2. Results The median β TPSF level for the whole patient group was 4.29 mg/L (range 0.33–51 mg/L). Cerebrospinal fluid leakage, as indicated by βTPSF/βTPSER > 2, was found to be present in 93% of the patients with CSDH and in 100% of the patients with SH (p = 0.724). In patients who later had to undergo repeated surgery for recurrence of CSDH/SH, the βTPSF concentrations (median 6.69 mg/L, range 0.59–51 mg/L) were significantly higher (p = 0.04) than in patients not requiring reoperation (median 4.12 mg/L, range 0.33–26.8 mg/L). Conclusions As indicated by the presence of βTP in the subdural fluid, CSF leakage into the subdural space is present in the vast majority of patients with CSDH and SH. This leakage could be involved in the pathogenesis of CSDH and SH. Patients who experience recurrences of CSDH and SH have significantly higher concentrations of βTPSF at initial presentation than patients not requiring reoperation for recurrence. These findings are presented in the literature for the first time and have to be confirmed and expanded upon by further studies.

Production of clinical form of chronic subdural hematoma in experimental animals

1972 ◽  
Vol 37 (5) ◽  
pp. 552-561 ◽  
Author(s):  
Satoru Watanabe ◽  
Hironobu Shimada ◽  
Shozo Ishii
Keyword(s):  
Cerebrospinal Fluid ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Subdural Space ◽  
Clinical Form ◽  
Content Type ◽  
Experimental Animals ◽  
Fine Print

✓ A method for producing a clinical form of experimental chronic subdural hematoma is reported. When blood is mixed with cerebrospinal fluid and incubated, a peculiar clot is formed which, when inoculated into the subdural space of dogs or monkeys, grows gradually. Histologically the capsule of the hematoma is comparable to that seen in human chronic subdural hematoma. In some animals progressive hemiparesis develops.

scholarly journals Subgaleal shunting: A 20-year experience

2000 ◽  
Vol 9 (6) ◽  
pp. 1-5 ◽  
Author(s):  
Martin H. Savitz ◽  
Leonard I. Malis
Keyword(s):  
Cerebrospinal Fluid ◽  
Chronic Subdural Hematoma ◽  
Term Treatment ◽  
Subdural Space ◽  
Increased Intracranial Pressure ◽  
Short Term ◽  
Open Drainage ◽  
Short Term Treatment ◽  
Cerebral Contusion ◽  
Subgaleal Space

Object The authors undertook a retropective study to evaluate the effectiveness of diverting intracranial fluid into the subgaleal space for temporary absorption by the membranes of the scalp. Methods Eighty-one patients were treated over a 20-year period. There were 22 cases of hypertensive hydrocephalus, 52 cases of acute head trauma, and seven cases of chronic subdural hematoma. The simple surgical technique is described. Subgaleal shunting provided effective short-term treatment of hydrocephalus and increased intracranial pressure, which was monitored directly in 22 cases of cerebral contusion and edema. Conclusions The closed method for drainage of cerebrospinal fluid avoids the complications of open ventriculostomy or open drainage of the subdural space.

Carcinoma Associated with Lipomeningocele

Neurosurgery ◽  
1979 ◽  
Vol 5 (2) ◽  
pp. 268-269 ◽  
Author(s):  
Giovanni Marini ◽  
Angelo Bollati ◽  
Giuseppe Galli ◽  
Massimo Gandolfini
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Benign Lesion ◽  
Fistulous Tract ◽  
Spinal Fluid ◽  
Malignant Degeneration ◽  
Subdural Space ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Chronic Irritation

Abstract We report the case of a 41-year-old man with an epidermoid carcinoma that had developed on a meningocele with a fistulous tract that chronically drained cerebrospinal fluid. After a review of the literature, we discuss the cause of this rare occurrence. We think that the recurrent discharge of spinal fluid (never complicated by meningitis) may have caused a chronic irritation of the tissues and then the delayed development of a carcinoma, which is similar to a case found in the literature. In our case there was a “flow” of carcinomatous cells along the fistula, which entered the meningocele, invading the subdural space as far as the peduncle. Our patient, who had a benign lesion (meningocele), came under neurosurgical care only after the lesion had degenerated. The malignant degeneration of such a benign lesion emphasizes the need for surgical treatment as soon as possible.

The morphology of cerebrospinal fluid drainage pathways in human arachnoid granulations

1985 ◽  
Vol 63 (6) ◽  
pp. 867-875 ◽  
Author(s):  
Margaret L. Upton ◽  
Roy O. Weller
Keyword(s):  
Cerebrospinal Fluid ◽  
Subarachnoid Space ◽  
Cerebrospinal Fluid Drainage ◽  
Subdural Space ◽  
Serial Sections ◽  
Arachnoid Granulations ◽  
Content Type ◽  
Endothelial Surface ◽  
Fine Print ◽  
Scanning Electron

✓ Arachnoid granulations and villi from 23 brains from subjects aged 9 to 84 years were examined post mortem by serial sections with the light microscope and as whole or fractured preparations in the scanning electron microscope. The object of the study was to investigate the pathways within the arachnoid granulations by which cerebrospinal fluid (CSF) drains from the subarachnoid space to the sinus endothelium. At the base of each granulation, a thin neck of arachnoid projects through an aperture in the dural lining of the sinus and expands to form a core of collagenous trabeculae and interwoven channels. An apical cap of arachnoid cells, about 150 µm thick, surmounts the collagenous core, and channels extend through the cap to reach subendothelial regions of the granulation. Channels within the granulation are lined by compacted collagen and may contain macrophages. Following recent subarachnoid hemorrhage, erythrocytes are found in the channels, suggesting that the channels are in continuity with the subarachnoid space and are CSF drainage pathways. The cap region of the granulation is only attached to the endothelium over an area 300 µm in diameter; the rest of the granulation core is separated from the endothelium by a subdural space and a fibrous dural cupola. Scanning electron microscopy reveals an intact endothelial surface to the granulations with small perforating venous channels present on the apex of some granulations. The differences between human arachnoid granulations and arachnoid villi in animals are discussed, together with preliminary observations regarding the transition of villi into granulations in man.

Tension Pneumocephalus of the Cranial Subdural Space

Neurosurgery ◽  
1979 ◽  
Vol 5 (3) ◽  
pp. 368-370 ◽  
Author(s):  
Peter McL. Black ◽  
James M. Davis ◽  
Raymond N. Kjellberg ◽  
Kenneth R. Davis
Keyword(s):  
Cerebrospinal Fluid ◽  
Rapid Diagnosis ◽  
Cerebrospinal Fluid Drainage ◽  
Subdural Space ◽  
Tension Pneumocephalus ◽  
Prompt Treatment ◽  
Drainage Device ◽  
Computerized Cranial Tomography

Abstract A case of subdural tension pneumocephalus is presented. Computerized cranial tomography permitted rapid diagnosis including localization of the air, thus facilitating prompt treatment. Tension pneumocephalus should be considered in a patient with a cerebrospinal fluid drainage device who deteriorates after craniotomy.

scholarly journals Subdural Hygroma: A Morbid Complication of Intrathecal Chemotherapy in a Patient with B-Cell Acute Lymphocytic Leukemia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mina Shenouda ◽  
Madhulika Urella ◽  
Jennifer Dotson ◽  
Hassaan Yasin ◽  
Yehuda Lebowicz
Keyword(s):  
Cerebrospinal Fluid ◽  
B Cell ◽  
Lumbar Puncture ◽  
Acute Lymphocytic Leukemia ◽  
Rare Complication ◽  
Intrathecal Chemotherapy ◽  
Lymphocytic Leukemia ◽  
Subdural Space ◽  
Subdural Hygroma

A subdural hygroma is an accumulation of cerebrospinal fluid in the subdural space that may occur secondary to trauma and surgery, or for iatrogenic reasons, such as a lumbar puncture. Lumbar puncture is a procedure used commonly for intrathecal chemotherapy for patients with B-cell acute lymphocytic leukemia (B-ALL) though subdural hygroma is a very rare complication. We present a case of a fatal, refractory subdural hygroma in a patient with B-ALL.

Sign in / Sign up

Export Citation Format

Share Document