Surgically treated traumatic subdural hematomas

1972 ◽  
Vol 37 (2) ◽  
pp. 137-149 ◽  
Author(s):  
Kenneth G. Jamieson ◽  
John D. N. Yelland
Keyword(s):  
Clinical Course ◽  
Injury Rate ◽  
Operative Procedures ◽  
Content Type ◽  
Subdural Hematomas ◽  
Fluid Collections ◽  
Fine Print

✓ The authors analyze 553 cases of surgically treated traumatic subdural hematomas. Simple subdural hematomas, subdural hematomas associated with cerebral lacerations, and subdural fluid collections are identified as three separate types. Age, sex, mechanism and cause of injury, rate of presentation, operative procedures, and outcome are discussed to illustrate differing pathogenesis, clinical course, and treatment.

Factors affecting coagulation: fibrinolysis in chronic subdural fluid collections

1983 ◽  
Vol 58 (2) ◽  
pp. 242-245 ◽  
Author(s):  
Bryce Weir ◽  
Philip Gordon
Keyword(s):  
Degradation Products ◽  
Hemoglobin Content ◽  
Fibrin Degradation Product ◽  
Content Type ◽  
Factors Affecting ◽  
Fibrin Degradation Products ◽  
Subdural Hematomas ◽  
Increased Risk ◽  
Fluid Collections ◽  
Fine Print

✓ Plasminogen, alpha2-antiplasmin, fibrinogen, fibrin degradation products (FDP's), and hemoglobin were measured in the supernatant fluid of 25 chronic subdural hematomas and five chronic subdural hygromas. The 30 patients underwent pre- and postoperative computerized tomography. The hematomas were characterized by low fibrinogen and high fibrin degradation product concentrations. The hemoglobin content varied directly with the alpha2-antiplasmin, and inversely with the plasminogen. Four patients underwent reoperation for recurrences. The initial fluid from these cases was characterized by relatively high plasminogen and low alpha2-antiplasmin. The hygromas had no hemoglobin, and low fibrinogen, high FDP's, low alpha2-antiplasmin, and variable plasminogen levels. It is possible that those cases having the greatest capacity to produce plasmin (high plasminogen and low alpha2-antiplasmin) can produce more FDP's which in turn causes more rebleeding and an increased risk of reaccumulation of chronic subdural hematomas.

Chronic spinal subdural hematomas

1985 ◽  
Vol 63 (4) ◽  
pp. 636-639 ◽  
Author(s):  
Virender K. Khosla ◽  
Vijay K. Kak ◽  
Suresh N. Mathuriya
Keyword(s):  
Subdural Hematoma ◽  
Clinical Course ◽  
Complete Recovery ◽  
Pertinent Literature ◽  
Content Type ◽  
Subdural Hematomas ◽  
Surgical Evacuation ◽  
Spinal Subdural Hematoma ◽  
Fine Print

✓ Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clinical course, not previously documented in the literature. Surgical evacuation resulted in almost complete recovery. The pathogenesis of spinal subdural hematoma is discussed and the pertinent literature is reviewed.

Rapid spontaneous resolution of acute extradural and subdural hematomas

1993 ◽  
Vol 78 (1) ◽  
pp. 126-128 ◽  
Author(s):  
Toshihiko Kuroiwa ◽  
Harushi Tanabe ◽  
Hiroyuki Takatsuka ◽  
Motohiro Arai ◽  
Nobuyoshi Sakai ◽  
...  
Keyword(s):  
Spontaneous Resolution ◽  
Content Type ◽  
First Report ◽  
Simultaneous Resolution ◽  
Subdural Hematomas ◽  
Fine Print

✓ The rapid spontaneous resolution of two traumatic acute hematomas, one extradural and one subdural, is reported in a 17-year-old young man. The authors believe that this is the first report of simultaneous resolution of both types of hematoma.

Extradural and subdural hematomas

1970 ◽  
Vol 33 (6) ◽  
pp. 632-635 ◽  
Author(s):  
Kenneth G. Jamieson
Keyword(s):  
Traffic Accidents ◽  
Head Injuries ◽  
Accident Prevention ◽  
Content Type ◽  
Subdural Hematomas ◽  
Fine Print

✓ The pattern of head injuries due to traffic accidents has changed markedly in Australia in the period since 1935. A review of autopsy cases of extradural and acute subdural hematomas shows a startling shift toward inoperable lesions. The author points out that accident prevention must now be considered the chief means of reversing man's trend toward self-destruction on the highway.

The contrast-enhanced CT scan in the diagnosis of isodense subdural hematoma

1979 ◽  
Vol 50 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Fong Y. Tsai ◽  
James E. Huprich ◽  
Hervey D. Segall ◽  
James S. Teal
Keyword(s):  
Cerebral Cortex ◽  
Ct Scan ◽  
Subdural Hematoma ◽  
Correct Diagnosis ◽  
Content Type ◽  
Subdural Hematomas ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Fine Print

✓ The authors review 29 cases of surgically-proven isodense subdural hematomas examined by non-contrast and contrast-enhanced computerized tomography scans. Three types of isodense collections were noted: homogeneous isodense collections, mixed-density collections, and gravitational layering within subdural collections. Contrast enhancement within the cerebral cortex, cortical vessels, and subdural membranes led to the correct diagnosis in each case. Contrast-enhanced scans are essential for the evaluation of isodense subdural hematomas.

Acute subdural hematoma

1982 ◽  
Vol 57 (2) ◽  
pp. 254-257 ◽  
Author(s):  
Henry A. Shenkin
Keyword(s):  
Computerized Tomography ◽  
Subdural Hematoma ◽  
Neurological Status ◽  
Neurological Dysfunction ◽  
Acute Subdural Hematoma ◽  
Consecutive Series ◽  
Content Type ◽  
Subdural Hematomas ◽  
Fine Print

✓ In a consecutive series of 39 cases of acute subdural hematoma (SDH), encountered since computerized tomography diagnosis became available, 61.5% were found to be the result of bleeding from a small cortical artery, 25.6% were of venous origin, 7.7% resulted from cerebral contusions, and 5% were acute bleeds into chronic subdural hematomas. Craniotomy was performed promptly on admission, but there was no difference in survival (overall 51.3%) between patients with arterial and venous bleeds. The only apparent factor affecting survival in this series was the preoperative neurological status: 67% of patients who were decerebrate and had fixed pupils prior to operation died. Of patients with less severe neurological dysfunction, only 20% failed to survive.

Terminal ventriculostomy for syringomyelia

1977 ◽  
Vol 46 (5) ◽  
pp. 609-617 ◽  
Author(s):  
W. James Gardner ◽  
Herbert S. Bell ◽  
Pete N. Poolos ◽  
Donald F. Dohn ◽  
Marta Steinberg
Keyword(s):  
Clinical Course ◽  
Adult Life ◽  
Central Canal ◽  
Conus Medullaris ◽  
Fetal Life ◽  
Filum Terminale ◽  
Content Type ◽  
Fine Print

✓ The clinical course of 12 patients who underwent terminal ventriculostomy for syringomyelia is presented. Opening the central canal at the tip of the conus medullaris is a relatively benign procedure that improves the symptoms of syringomyelia and syringobulbia. This canal normally terminates at the tip of the conus, but in each of the 12 surgical specimens it continued into the filum terminale for distances up to 8 cm. In most cases the tip of the conus was located more caudally than normal, indicating some degree of tethering in fetal life. This belief is supported by the fact that the newborn, whose conus is tethered to a lipoma at the sacral level, may develop syringomyelia in adult life.

Angioplasty for basilar artery atherosclerosis

1992 ◽  
Vol 77 (6) ◽  
pp. 941-944 ◽  
Author(s):  
Arvind Ahuja ◽  
Lee R. Guterman ◽  
Leo N. Hopkins
Keyword(s):  
Basilar Artery ◽  
Balloon Angioplasty ◽  
Medical Management ◽  
Clinical Course ◽  
Anticoagulation Therapy ◽  
Transient Ischemic Attacks ◽  
Content Type ◽  
Severe Atherosclerosis ◽  
Percutaneous Transluminal ◽  
Fine Print

✓ A case is presented of severe atherosclerosis of the basilar artery, successfully treated with percutaneous transluminal balloon angioplasty. Crescendo daily transient ischemic attacks consisted of alternating hemiplegia and were refractory to medical management, including anticoagulation therapy. The clinical course, endovascular treatment, and results are described. Prior published experiences with this condition are reviewed.

Spontaneous chronic subdural hematomas in young adults with a deficiency of coagulation factor XIII

2005 ◽  
Vol 102 (6) ◽  
pp. 1130-1132 ◽  
Author(s):  
Alessio Albanese ◽  
Antonio Tuttolomondo ◽  
Carmelo Anile ◽  
Giovanni Sabatino ◽  
Angelo Pompucci ◽  
...  
Keyword(s):  
Young Adults ◽  
Factor Xiii ◽  
Coagulation Factor ◽  
Content Type ◽  
Coagulation Factor Xiii ◽  
Subdural Hematomas ◽  
History Of ◽  
Bridging Veins ◽  
Fine Print

✓ Chronic subdural hematomas (SDHs) generally occur in elderly patients. Its pathogenesis is usually related to head trauma with tearing and rupture of the bridging veins, although in some cases a history of trauma is not recognizable. There are many reports regarding the association between spontaneous chronic SDHs and an alteration in coagulative parameters. A coagulative disorder should be suspected when an unexplained hemorrhage occurs, especially in a young patient. The authors report on three young men with a deficiency in coagulation factor XIII (FXIII) who underwent surgery for chronic SDHs. The role of FXIII in the pathogenesis of chronic SDH is emphasized. In patients with unexplained chronic SDH all coagulation parameters and factors should be screened to identify an eventual coagulative disorder.

Papillomas and carcinomas of the choroid plexus in children

1998 ◽  
Vol 88 (3) ◽  
pp. 521-528 ◽  
Author(s):  
Philippe Pencalet ◽  
Christian Sainte-Rose ◽  
Arielle Lellouch-Tubiana ◽  
Chantal Kalifa ◽  
Francis Brunelle ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Surgical Excision ◽  
Preoperative Embolization ◽  
Older Children ◽  
Complete Excision ◽  
Choroid Plexus Tumors ◽  
Content Type ◽  
Intraventricular Tumors ◽  
Fluid Collections ◽  
Fine Print

Object. Choroid plexus tumors are rare intraventricular tumors (1% of all intracranial tumors) that occur mainly in children. The pathophysiological characteristics of associated hydrocephalus, surgical management, and oncological issues related to these tumors remain a matter of debate. To understand more about these tumors, the authors have reviewed their experience with the management of 38 children with choroid plexus tumors. Methods. There were 25 cases of papilloma and 13 of carcinoma. The mean age of the patients at presentation was 22.5 months, and one-half of the patients were younger than 2 years of age. Hydrocephalus was present in 33 patients and poorly correlated with the size, site, and pathological characteristics of the tumor. In nine children, a ventriculoperitoneal shunt was required after tumor excision, calling into question the notion that cerebrospinal fluid oversecretion is the only cause of hydrocephalus. Complete excision was achieved in 96% of the cases of papilloma and 61.5% of the cases of carcinoma. These surgical procedures were complicated by the risks of intraoperative hemorrhage, which proved to be fatal in two cases, and postoperative brain collapse, which led to subdural fluid collections requiring subdural shunt placement in six patients. Preoperative embolization was partially successful in four cases and significantly assisted surgery. Preoperative controlled drainage of excessively dilated ventricles and intraoperative gluing of the cortical incision have been used to address the problem of postoperative brain collapse. Patients with carcinomas were treated postoperatively by chemotherapy alone (seven cases), radiotherapy (one case), or chemotherapy plus radiotherapy (one case). The overall 5-year survival rate was 100% for patients with papillomas and 40% for those with carcinomas. Conclusions. Total surgical excision is curative in cases of papillomas. For carcinomas, the most effective treatment remains total surgical excision; however, adjuvant treatment in the form of chemotherapy in patients younger than age 3 years, supplemented by radiation therapy in older children, can moderately reduce the risk of recurrence.

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