Rapid evacuation of chronic subdural hematoma – A possible traumatic brain injury (TBI)

2020 ◽  
Vol 137 ◽  
pp. 109539 ◽  
Author(s):  
Orlin Pavlov
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Rapid Evacuation

scholarly journals Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma

2012 ◽  
pp. 161-167 ◽  
Author(s):  
V. HÁNA ◽  
M. KOSÁK ◽  
V. MASOPUST ◽  
D. NETUKA ◽  
Z. LACINOVÁ ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Diabetes Insipidus ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Clinical Severity ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Dysfunction ◽  
One Year

Relatively frequent pituitary hormone deficiencies are observed after traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) and according to the published studies the neuroendocrine consequenses of traumatic brain injury are underdiagnosed. In a cohort of 59 patients (49 males, mean age 68.3 years, 36-88 years) after evacuation of subdural hematoma (SDH) were evaluated hypothalamo-pituitary functions one week after surgery, after three months and after one year. Hypogonadism was present in 26 % of patients in an acute phase, but in the majority had a transient character. Less than half of patients was GH deficient (GHD) according to the GHRH+arginine test. We did not find any serious case of hypocortisolism, hypothyroidism, diabetes insipidus centralis nor syndrome of inappropriate secretion of ADH (SIADH). Transient partial hypocortisolism was present in two cases, but resolved. We did not find relation between extension of SDH or clinical severity and development of hypopituitarism. In conclusion, in some patients with SDH growth hormone deficiency or hypogonadism was present. No serious hypocortisolism, hypothyroidism, diabetes insipidus nor SIADH was observed. The possibility of neuroendocrine dysfunction should be considered in patients with SDH, although the deficits are less frequent than in patients after TBI or SAH.

scholarly journals Clinical application of magnetic resonance in acute traumatic brain injury

2008 ◽  
Vol 66 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Dionei F. Morais ◽  
Antonio R. Spotti ◽  
Waldir A. Tognola ◽  
Felipe F.P. Gaia ◽  
Almir F. Andrade
Keyword(s):  
Traumatic Brain Injury ◽  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Subdural Hematoma ◽  
Diffuse Axonal Injury ◽  
Correlation Method ◽  
Acute Subdural Hematoma ◽  
Acute Traumatic Brain Injury ◽  
Magnetic Resonance Imaging Mri

PURPOSE: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. METHOD: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. RESULTS: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. CONCLUSION: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.

Serendipity and the Subdural Hematoma

Biofeedback ◽  
2009 ◽  
Vol 37 (3) ◽  
pp. 108-111
Author(s):  
Jay Gunkelman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Subdural Hematoma ◽  
Imaging Studies ◽  
Word Finding ◽  
Life Threatening ◽  
The Individual ◽  
The Brain ◽  
Effect Of Age

Abstract Mild traumatic brain injury is often missed in the course of treating other injuries. This failure to identify the brain injury can be critically important, even life threatening. This report shows one such case in which the brain injury was overlooked, possibly because of the differential effect of age on the severity of the damage incurred from what appeared to be a mild trauma. Distant to the time of the injury, deficits in speech fluency and word finding led the individual to seek further evaluation, and imaging studies revealed a large subdural hematoma. CT scan images are included.

HYPEREMIA BENEATH EVACUATED ACUTE SUBDURAL HEMATOMA IS FREQUENT AND PROLONGED IN PATIENTS WITH AN UNFAVORABLE OUTCOME

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. 705-718 ◽  
Author(s):  
Arturo Chieregato ◽  
Alberto Noto ◽  
Alessandra Tanfani ◽  
Giovanni Bini ◽  
Costanza Martino ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Subdural Hematoma ◽  
Time Course ◽  
Unfavorable Outcome ◽  
Acute Subdural Hematoma ◽  
Control Group ◽  
Computed Tomographic ◽  
The Mean

Abstract OBJECTIVE To verify the values and the time course of regional cerebral blood flow (rCBF) in the cortex located beneath an evacuated acute subdural hematoma (SDH) and their relationship with neurological outcome. METHODS rCBF levels were measured in multiple regions of interest, by means of a Xe-computed tomographic technique, in the cortex underlying an evacuated SDH and contralaterally in 20 patients with moderate or severe traumatic brain injury and an evacuated acute SDH. Twenty-three patients with moderate or severe traumatic brain injury and an evacuated extradural hematoma or diffuse injury served as the control group. Outcome was evaluated by means of the Glasgow Outcome Scale at 12 months. RESULTS Values for the maximum (rCBFmax) and the mean of all rCBF levels in the cortex beneath the evacuated SDH were more frequently consistent with hyperemia. The side-to-side differences in the mean of all rCBF and rCBFmax levels between lesioned and nonlesioned hemispheres were greater in patients with evacuated SDH than in controls (P = 0.0013 and P = 0.0018, respectively). The side-to-side difference in the maximum rCBF value was higher in SDH patients with unfavorable outcomes than in controls at 24 to 96 hours and at 4 to 7 days and higher than in patients with favorable outcomes at 4 to 7 days. The widest side-to-side difference in rCBFmax value was more elevated in patients with an evacuated SDH with unfavorable outcome than in patients with a favorable outcome (P = 0.047), whereas no differences were found in controls. The SDH thickness and the associated midline shift were greater in patients with unfavorable outcomes than in those with favorable outcomes. CONCLUSION On average, hyperemic long-lasting rCBF values frequently occur in the cortex located beneath an evacuated SDH and seem to be associated with unfavorable outcome.

scholarly journals Acute Subdural Hematoma after Isolated Traumatic Brain Injury: Risk Factors and Prediction of Mortality

2015 ◽  
Vol 25 (2) ◽  
pp. 36-40
Author(s):  
Dalia Adukauskienė ◽  
Asta Mačiulienė ◽  
Aušra Čiginskienė ◽  
Agnė Adukauskaitė ◽  
Justina Čyžiūtė
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Cell ◽  
Cell Count ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Blood Cell Count ◽  
Lethal Outcome ◽  
Pupil Reaction

The aim of this study was to determine mortality and it‘s risk factors also prediction of lethal outcome in case of acute subdural hematoma after isolated traumatic brain injury (ITBI). Methods. A retrospective study of 162 patients after ITBI was carried out in Neurosurgical Intensive Care Unit (NITS) of Lithuanian University of Health Sciences Hospital (LUHSH) Kaunas Clinics (KC). Demographic (gender, age), clinical (pupil reaction to light, Glasgow Coma Scale (GCS) score, APACHE II scale score) and laboratory (white blood cell count, glycemia) data analysis on the first day after the injury was made. Conclusions. The mortality rate of acute subdural hematoma after isolated traumatic brain injury was 41 pct. Risk factors of mortality were estimated to be patient age ≥ 65 yrs, absence of pupil reaction to light, GCS 3-8, APACHE II score ≥ 16 points, white blood cell count ≥10,1 x 109/l and glycemia ≥5,6mmol/l. It was estimated the evident relation between predicted lethal outcome and real mortality when the risk of lethal outcome was higher than 25 pct.

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