Results of Surgically Treated Acute Subdural Hematoma Caused by Head Injury

2015 ◽  
Vol 76 (S 02) ◽  
Author(s):  
Antun Azasevac ◽  
T. Cigić ◽  
V. Papić ◽  
Đ. Đilvesi ◽  
N. Krajčinović ◽  
...  
Keyword(s):  
Head Injury ◽  
Subdural Hematoma ◽  
Acute Subdural Hematoma

Acute brain edema in fatal head injury: analysis by dynamic CT scanning

1985 ◽  
Vol 63 (6) ◽  
pp. 830-839 ◽  
Author(s):  
Eiji Yoshino ◽  
Tarumi Yamaki ◽  
Toshihiro Higuchi ◽  
Yoshiharu Horikawa ◽  
Kimiyoshi Hirakawa
Keyword(s):  
Head Injury ◽  
Brain Edema ◽  
Subdural Hematoma ◽  
Ct Scans ◽  
Acute Subdural Hematoma ◽  
Dynamic Ct ◽  
Content Type ◽  
Injured Patients ◽  
Fine Print ◽  
Diffuse Brain

✓ Dynamic computerized tomography (CT) was performed on 42 patients with acute head injury to evaluate the hemodynamics and to elucidate the nature of fatal diffuse brain bulk enlargement. Patients were divided into two groups according to the outcome: Group A included 17 nonfatally injured patients, eight with acute epidural hematomas and nine with acute subdural hematomas; Group B included 25 fatally injured patients, 16 with acute subdural hematomas and nine with bilateral brain bulk enlargement. Remarkable brain bulk enlargement could be seen in all fatally injured patients with acute subdural hematoma. In 29 (69%) of 42 patients, dynamic CT was performed within 2 hours after the impact. In the nonfatally injured patients with brain bulk enlargement, dynamic CT scans suggested a hyperemic state. On the other hand, in 17 (68%) of the 25 fatally injured patients, dynamic CT scans revealed a severely ischemic state. In the fatally injured patients with acute subdural hematoma, CT Hounsfield numbers in the enlarged hemisphere (hematoma side) were significantly lower than those of the opposite side (p < 0.001). Severe diffuse brain damage confirmed by follow-up CT scans and uncontrollable high intracranial pressure were noted in the fatally injured patients. Brain bulk enlargement following head injury originates from acute brain edema and an increase of cerebral blood volume. In cases of fatal head injury, acute brain edema is the more common cause of brain bulk enlargement and occurs more rapidly than is usually thought.

Mortality Outcome of Emergency Decompressive Craniectomy and Craniotomy in the Management of Acute Subdural Hematoma: A National Data Analysis

2020 ◽  
pp. 000313482095146
Author(s):  
Nasim Ahmed ◽  
Patricia Greenberg ◽  
SeungHoon Shin
Keyword(s):  
Head Injury ◽  
Hospital Mortality ◽  
Decompressive Craniectomy ◽  
Subdural Hematoma ◽  
Severe Head Injury ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Univariate Analysis ◽  
Acute Subdural Hematoma ◽  
Significant Difference

Background The purpose of the study is to evaluate the in-hospital mortality of patients who presented with acute subdural hematoma (SDH) and underwent emergency decompressive craniectomy (DC) or craniotomy (CO) within 4 hours of hospital arrival. Method The National Trauma Data Bank (NTDB) dataset of the calendar year of 2007 through 2010 was accessed for the study. All blunt severe head injury patients who presented with acute SDH were included in the study. Severe head injury is defined as a head Abbreviated Injury Scale (AIS) score ≥3 and a Glasgow Coma Scale (GCS) score ≤8. Univariate followed by propensity-matched analyses were performed to compare the two procedure groups: DC and CO. Results Out of 2370 patients, 518, (21.9%) patients underwent DC. There were significant differences found in the univariate analysis between the DC and CO groups for median age (38 (IQR: 22.0, 55.0) vs 49 (IQR: 27, 67), P < .001), mechanism of injury (fall: 33.2% vs 50.7%; motor vehicle crashes: 58.3% vs 40.9%, P < .001), and median injury severity score (ISS: 26.0 (IQR: 25, 38) vs 26 (IQR: 25.0, 33.0), P < .001). After propensity score matching and pair-matched analysis, no differences were found with any of the above characteristics. The pair-matched analysis also showed no significant difference in in-hospital mortality (42.7% vs 37.5%, P = .10) between the DC vs CO groups. Conclusion The overall in-hospital mortality for emergency CO or DC for the evacuation of SDH remains high. The preference of one operative procedure over the other did not impact overall mortality.

Acute subdural hematoma and diffuse axonal injury after severe head trauma

1988 ◽  
Vol 68 (6) ◽  
pp. 894-900 ◽  
Author(s):  
Juan Sahuquillo-Barris ◽  
Jose Lamarca-Ciuro ◽  
Jorge Vilalta-Castan ◽  
Enrique Rubio-Garcia ◽  
Manuel Rodriguez-Pazos
Keyword(s):  
Head Injury ◽  
Subdural Hematoma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Acute Subdural Hematoma ◽  
Content Type ◽  
Hypoxic Brain ◽  
Clinicopathological Findings

✓ The association of acute subdural hematoma (SDH) and diffuse axonal injury has received little attention in the literature. The authors report the clinicopathological findings in six patients who died of severe head injury in whom computerized tomography revealed acute SDH as the predominant lesion. All patients were injured in road traffic accidents and lost consciousness on impact. The mean total contusion index was 17.4 and severe contusions were seen in only two cases. All patients presented histological criteria of intracranial hypertension (pressure necrosis focus in one or both parahippocampal gyri). Hypoxic brain damage was evident in the postmortem examination of three patients. In three cases, macroscopic hematic lesions were observed in the corpus callosum. All patients had widespread axonal retraction balls disseminated in the white brain matter. Three patients who survived for more than 11 days had microglial clusters. In some patients with a head injury, acute SDH may be only an epiphenomenon of a primary impact lesion of variable severity: that is, a diffuse axonal injury. In these cases, the final outcome is fundamentally dependent on the severity of the subjacent diffuse axonal injury.

Delayed intraventricular hemorrhage with hydrocephalus following evacuation of post traumatic acute subdural hematoma

2007 ◽  
Vol 04 (02) ◽  
pp. 119-122 ◽  
Author(s):  
Raj Kumar ◽  
Samir Kumar Kalra ◽  
Rupant Kumar Das ◽  
Vivek Kumar Vaid ◽  
Ashok Kumar Mahapatra
Keyword(s):  
Head Injury ◽  
Vascular Malformation ◽  
Subdural Hematoma ◽  
Intraventricular Hemorrhage ◽  
Acute Subdural Hematoma ◽  
Ventricular Wall ◽  
Post Traumatic ◽  
Underlying Pathophysiology

AbstractThe incidence of intraventricular hemorrhage (IVH) has been increasing recently due to increased detection. The occurrence following evacuation of an acute subdural hematoma (SDH) is extremely rare. The exact mechanism of traumatic IVH in these cases has not been well documented; the erosion of the ventricular wall by adjacent hematoma has been described as the most plausible cause. The rupture of unsuspected vascular malformation following head injury has also been suggested.A case with a delayed IVH following evacuation of acute SDH is reported and the underlying pathophysiology is discussed. This entity needs to recognized and kept in mind as a potential cause of post surgical deterioration in such patients.

scholarly journals Acute subdural hematoma and diffuse axonal injury in fatal road traffic accident victims: a clinico-pathological study of 15 patients

2003 ◽  
Vol 61 (3B) ◽  
pp. 746-750 ◽  
Author(s):  
Sebastião Nataniel Silva Gusmão ◽  
José Eymard Homem Pittella
Keyword(s):  
Head Injury ◽  
Hospital Admission ◽  
Subdural Hematoma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Acute Subdural Hematoma ◽  
Road Traffic Accidents ◽  
Pathological Study

OBJECTIVE: Although acute subdural hematoma (ASDH) and diffuse axonal injury (DAI) are commonly associated in victims of head injury due to road traffic accidents, there are only two clinico-pathological studies of this association. We report a clinical and pathological study of 15 patients with ASDH associated with DAI. METHOD: The patients were victims of road traffic accidents and were randomly chosen. The state of consciousness on hospital admission was evaluated by the Glasgow coma scale. For the identification of axons the histological sections of the brain were stained with anti-neurofilament proteins. RESULTS: Twelve of the 15 patients were admitted to hospital in a state of coma; in three patients, the level of consciousness was not evaluated, as they died before hospital admission. CONCLUSION: The poorer prognosis in patients with ASDH who lapse into coma immediately after sustaining a head injury, as described by several authors, can be explained by the almost constant association between ASDH and DAI in victims of fatal road traffic accidents.

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