scholarly journals Chronic Subdural Hematoma after External Decompression in Traumatic Intracranial Hematoma

1987 ◽  
Vol 27 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Shuichi OKI ◽  
Takashi YOSHIHARA ◽  
Masuki KOBAYASHI ◽  
Shiro KAJIHARA ◽  
Katsuaki SAKODA ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Intracranial Hematoma ◽  
Traumatic Intracranial Hematoma

scholarly journals Poūmių trauminių intrakranijinių hematomų vėlyvas chirurginis gydymas

2004 ◽  
Vol 2 (3) ◽  
pp. 0-0
Author(s):  
Rimantas Vilcinis ◽  
Juozas Šidiškis
Keyword(s):  
Subdural Hematoma ◽  
Neurological Deficit ◽  
Epileptic Seizures ◽  
Burr Hole ◽  
University Hospital ◽  
Intracranial Hematoma ◽  
Post Injury ◽  
Focal Neurological Deficit ◽  
Intracranial Hematomas ◽  
Traumatic Intracranial Hematoma

Rimantas Vilcinis, Juozas ŠidiškisKauno medicinos universiteto klinikųNeurochirurgijos klinikosGalvos smegenų traumų skyrius,Eivenių g. 2, LT–50009, KaunasEl. paštas [email protected] Įvadas / tikslas Dalis trauminių intrakranijinių hematomų kliniškai pasireiškia po trijų dienų ar vėliau. Darbo tikslas – įvertinti poūmių trauminių intrakranijinių hematomų dažnį, rūšis, traumos mechanizmus, operacijos indikacijas ir jos terminą, gydymo komplikacijas ir rezultatus. Tuo remdamiesi pateikiame poūmių trauminių intrakranijinių hematomų gydymo rekomendacijas. Ligoniai ir metodai Retrospektyviai išanalizavome 1275 ligonius, operuotus nuo trauminių intrakranijinių hematomų (TIH) Kauno medicinos universiteto klinikų Galvos smegenų traumų skyriuje per 7 metus (1997–2002). Iš jų 50 ligonių išoperuotos poūmės intrakranijinės hematomos (PIH), kurios kliniškai pasireiškė ir buvo pašalintos tarp ketvirtos ir dvidešimt pirmos potrauminės paros. Hematoma pašalinta atliekant kraniotomiją 24 ligoniams. Kitiems 26 ligoniams pakako pašalinti suskystėjusią subduralinę hematomą uždaruoju būdu drenuojant subduralinį tarpą per trepanacinę frezinę angą. Rezultatai Iš 50 ligonių, kuriems pasireiškė poūmė intrakranijinė hematoma, 41-am nustatyta subduralinė hematoma, dviem – epiduralinė hematoma (iš jų vienam užpakalinėje kaukolės dauboje), vienam – smegenėlėse, vienam – smegenyse, ir penkiems – mišrios (subduralinė ir intracerebrinė) hematomos. Vidutinis hematomos storis, vertinant pagal kompiuterinę tomogramą (KT), – 1,12 ± 0,44 cm. Ligoniai buvo operuoti praėjus vidutiniškai 11,73 ± 5,46 paroms (4–21) po traumos. Operacijos indikacijos buvo: ilgalaikiai galvos skausmai, nepaisant skiriamo intensyvaus medikamentinio gydymo (27 ligoniams), didėjanti smegenų vidurinių struktūrų dislokacija KT (24-iems), stabilūs ar ryškėjantys židininiai neurologiniai simptomai (parezė – 14, disfazija – 10), dezorientacija (11), epilepsijos priepuoliai (6), stazė akių dugne (9), patologinis Babinskio refleksas (7), akių deviacija (4), bradikardija (3), anizokorija, šlapinimosi kontrolės sutrikimas, kraujosruvos akių dugne (po 1). Po kraniotomijos operacijos 3 ligoniams atsirado pooperacinės hematomos (2 epiduralinės ir 1 subduralinė), kurios sėkmingai pašalintos pakartotinės operacijos metu. Visi ligoniai po operacijos pasveiko, vienam ligoniui liko parezė ir dviem – daliniai kalbos sutrikimai. Išvados Traumines intrakranijines hematomas, nesukeliančias aiškių smegenų suspaudimo požymių, iš pradžių galima gydyti konservatyviai, įdėmiai stebint ligos eigą. Jei nėra ženklesnio būsenos pagerėjimo ar ji blogėja, tokius ligonius reikia operuoti, dažniausiai antrą savaitę po traumos. Jei kontrolinėse galvos KT matoma suskystėjusi subduralinė hematoma (izodensinė ir hipodensinė zona), pakanka ją drenuoti pro trepanacinę angą. Prasminiai žodžiai: poūmės trauminės intrakranijinės hematomos, kraniotomija, trepanacija, drenavimas Delayed surgical treatment of subacute traumatic intracranial hematomas Rimantas Vilcinis, Juozas Šidiškis Background / objective Some traumatic intracranial hematomas manifest clinically three and more days after injury. Our aim was to analyse their frequency, types, mechanisms of injury, indications for operation, surgical tactics and treatment results. Patients and methods We analysed retrospectively 50 (4%) patients with subacute intracranial hematoma among 1275 patients operated on for traumatic intracranial hematoma in Head Injury Department of Kaunas Medical University Hospital in 1997–2002. Craniotomy was done for 24 patients, and it was enough to drain liquid subdural hematoma through a burr hole in 26 cases. Results There were 41 subdural hematomas, 2 epidural (1 in posterior cranial fossa), 1 cerebellar, 1 intracerebral and 5 mixted (subdural and intracerebral) hematomas evacuated 3–21 days post injury. The average thickness of hematoma on CT was 1.12 ± 0.44 cm. The patients were operated on 4–21 (mean 11.73 ± 5.46) days post injury. The indications for surgery were: prolonged hypertensive headache (27 patients), the increase of midline dislocation on control CT (24 patients), stabile or deteriorating focal neurological deficit (paresis – 14, dysphasia – 10), disorientation (11), epileptic seizures (6), stasis in eye fundus (9), pathologic Babinski reflex (7), eye deviation (4), bradicardia (3), etc. There were 3 postoperative hematomas (2 epidural and 1 subdural), which were succesfully evacuated. All patients recovered, and the residual neurological deficit was paresis in 1 case and remnant disphasia in 2 patients. Conclusions Patients with traumatic intracranial hematoma, without clear signs of brain compression initially and treated conservatively, need surgery mainly on the second week after trauma. It is worthwhile to observe patients with small subdural hematoma, and if it does not resolve, liquid hematoma may be evacuated successfully through a burr hole the second week after injury. Keywords: subacute traumatic intracranial hematoma, craniotomy, burr hole, drainage

scholarly journals Meningeal Carcinomatosis for Prostate Adenocarcinoma Mimicking Chronic Subdural Hematoma: Case Report and Literature Review

2021 ◽  
Author(s):  
Tiago Silva Holanda Ferreira ◽  
Gilnard Caminha de Menezes Aguiar ◽  
Daniel Gurgel Fernandes Távora ◽  
Lucas Alverne Freitas de Albuquerque ◽  
Stélio da Conceição Araújo Filho
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Specific Antigen ◽  
Chronic Subdural Hematoma ◽  
Radical Resection ◽  
Prostate Adenocarcinoma ◽  
Meningeal Carcinomatosis ◽  
Motor Deficits ◽  
Friable Material ◽  
The Central Nervous System

Abstract Introduction Cerebral metastases are the most common cancer of the central nervous system (CNS). Meningeal infiltration by neoplasms that did not originate in the CNS is a rare fact that is present in 0.02% of the autopsies.Epidemiologically, the radiological presentation mimicking a subdural hematoma is even more uncommon. We report a case of meningeal carcinomatosis by an adenocarcinoma of the prostate mimicking a chronic subdural hematoma. Case Report A 60-year-old male patient was diagnosed with prostate cancer in 2011. He underwent radical resection of the prostate, as well as adjuvant hormonal therapy and chemotherapy.Five years later, the patient presented peripheral facial paralysis that evolved with vomiting and mental confusion. Tomography and magnetic resonance imaging scans confirmed the subdural collection.At surgery, the dura was infiltrated by friable material of difficult hemostasis. The anatomicopathological examination showed atypical epithelial cells. The immunohistochemistry was positive for prostate-specific antigen (PSA) and other key markers, and it was conclusive for meningeal carcinomatosis by a prostate adenocarcinoma. Discussion Meningeal carcinomatosis presents clinically with headache, motor deficits, vomiting, changes in consciousness and seizures.The two most discussed mechanisms of neoplastic infiltration are the hematogenous route and retrograde drainage by the vertebral venous plexus. Conclusion Variable clinical presentations may occur in dural metastases; however, the radiological presentation as subdural hematoma is rare. There are few descriptions of cases like this one in the literature.To support the diagnosis, the previous medical history is as important as the complementary exams and the radiological findings, because the symptoms are common at the neurological emergency. To our knowledge, this is the first report of a prostate neoplasm mimicking chronic subdural hematoma in Brazil.

scholarly journals Two Co(II) coordination polymers: magnetic properties and application values against chronic subdural hematoma

2021 ◽  
Vol 24 (1) ◽  
pp. 199-207
Author(s):  
Jing-Sen Chen ◽  
Sheng-Long Cao ◽  
Hai-Ying Hu ◽  
Juan Shen ◽  
Yu-Jun Qi
Keyword(s):  
Magnetic Properties ◽  
Coordination Polymers ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma

scholarly journals Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 257
Author(s):  
Ambooj Tiwari ◽  
Adam A. Dmytriw ◽  
Ryan Bo ◽  
Nathan Farkas ◽  
Phillip Ye ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Middle Meningeal Artery ◽  
Volumetric Analysis ◽  
Primary Therapy ◽  
Curative Therapy ◽  
Complete Obliteration ◽  
Embolization Treatment ◽  
Long Term Follow Up ◽  
Meningeal Artery

Objective: To study the efficacy of middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematoma (SDH) and characterize its post-embolization volumetric resolution. Methods: Ten patients diagnosed with 13 cSDH underwent MMA embolization. SDH volumes were measured from time of initial discovery on imaging to pre-operative, post-operative, short-term and long-term follow-up. Time between procedure to obliteration was also measured. Volumetric analysis was done using the coniglobus formula, and recurrence rate as well as resolution timeline was defined using best-fit models. Results: Out of 10 patients, five were recurrent lesions, three were bilateral and seven unilateral cSDH. Average and median pre-operative volumes were 105.3 cc and 97.4 cc, respectively. Embolization on average was performed 21 days after discovery. Sixty percent of patients had concurrent antiplatelets or anticoagulation use. Forty percent underwent embolization treatment as the primary therapy. Recurrence was not seen in any patients treated with embolization. There were no peri- or post-operative complications. Five patients experienced complete or near-complete obliteration, while those with partial resolution showed a composite average of 75% volumetric reduction in 45 days. Post-embolization, the volumetric resolution followed an exponential decay curve over time and was independent of initial volume. Conclusion: MMA embolization contributed to a marked reduction in SDH volume post-operatively and can be used as a curative therapy for primary or recurrent chronic SDH.

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