Rapid resolution of acute epidural hematoma

1988 ◽  
Vol 68 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Nobuhiko Aoki
Keyword(s):  
Epidural Hematoma ◽  
Clinical Course ◽  
Skull Fracture ◽  
Fracture Line ◽  
Concomitant Increase ◽  
Content Type ◽  
Rapid Resolution ◽  
Acute Epidural Hematoma ◽  
Fine Print

✓ Two cases of acute epidural hematoma with rapid resolution followed by a benign clinical course are reported. Because of the concomitant increase in the epicranial hematoma over a linear skull fracture in each case, the acute epidural hematoma was presumed to have been decompressed into the epicranial region through the fracture line.

Air in acute epidural hematomas

1986 ◽  
Vol 65 (4) ◽  
pp. 555-556 ◽  
Author(s):  
Nobuhiko Aoki
Keyword(s):  
Temporal Bone ◽  
Clinical Significance ◽  
Epidural Hematoma ◽  
Pediatric Patients ◽  
Skull Fracture ◽  
Air Bubbles ◽  
Content Type ◽  
Air Bubble ◽  
Acute Epidural Hematoma ◽  
Fine Print

✓ Two pediatric patients with acute epidural hematomas containing air bubble(s) are reported. A skull fracture was observed extending to the mastoid cells of the temporal bone in both patients. In one patient the hematoma and air bubbles subsequently increased in volume, requiring a craniotomy. The clinical significance of air in an acute epidural hematoma is discussed.

The management of “asymptomatic” epidural hematomas

1989 ◽  
Vol 70 (3) ◽  
pp. 392-396 ◽  
Author(s):  
Neville W. Knuckey ◽  
Steven Gelbard ◽  
Mel H. Epstein
Keyword(s):  
Risk Factors ◽  
Epidural Hematoma ◽  
Skull Fracture ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Management Protocol ◽  
Major Vessel ◽  
Low Incidence ◽  
A Prospective Study ◽  
Fine Print

✓ Standard neurosurgical management mandates prompt evacuation of all epidural hematomas to obtain a low incidence of mortality and morbidity. This dogma has recently been challenged. A number of authors have suggested that in selected cases small and moderate epidural hematomas may be managed conservatively with a normal outcome and without risk to the patient. The goal of this study was to define the clinical parameters that may aide in the management of patients with small epidural hematomas who were clinically asymptomatic at initial presentation because there was no clinical evidence of raised intracranial pressure or focal compression. A prospective study was conducted of 22 patients (17 males and five females) aged from 1 to 71 years, who had a small epidural hematoma diagnosed within 24 hours of trauma and were managed expectantly. Of these, 32% subsequently required evacuation of the epidural hematoma 1 to 10 days after the initial trauma. Analysis of the patients revealed that age, sex, Glasgow Coma Scale score, and initial size of the hematoma are not risk factors for deterioration. However, deterioration was seen in 55% of patients with a skull fracture transversing a meningeal artery, vein, or major sinus, and in 43% of those undergoing computerized tomography (CT) within 6 hours of trauma. In contrast, only 13% of patients in whom the diagnosis of a small epidural hematoma was delayed over 6 hours subsequently required evacuation of the epidural collection. Of patients with both risk factors, 71% required evacuation of the epidural hematoma. None of the patients suffered neurological sequelae attributable to this management protocol. It was concluded that patients with a small epidural hematoma, a fracture overlaying a major vessel or major sinus, and/or who are diagnosed less than 6 hours after trauma are at risk of subsequent deterioration and may require evacuation. Conversely, patients without these risk factors may be managed conservatively with repeat CT and careful neurological observation, because of the low risk of delayed deterioration.

Sequential angiographic studies demonstrating delayed development of an acute epidural hematoma

1978 ◽  
Vol 48 (3) ◽  
pp. 479-482 ◽  
Author(s):  
Robert Goodkin ◽  
John Zahniser
Keyword(s):  
Head Injury ◽  
Cerebral Angiography ◽  
Epidural Hematoma ◽  
Content Type ◽  
Delayed Development ◽  
Acute Epidural Hematoma ◽  
Fine Print

✓ A case is presented in which the delayed development of an acute epidural hematoma within 12 hours of a head injury was documented by serial cerebral angiography. A possible mechanism for the delayed evolution of the epidural hematoma is discussed.

Cortical arteriovenous fistula associated with skull fracture

1984 ◽  
Vol 60 (1) ◽  
pp. 192-195 ◽  
Author(s):  
Paul A. LaHaye ◽  
Pablo M. Lawner
Keyword(s):  
Arteriovenous Fistula ◽  
Surgical Therapy ◽  
Clinical Course ◽  
Skull Fracture ◽  
Fracture Site ◽  
Neurological Deterioration ◽  
Vascular Injuries ◽  
Content Type ◽  
Delayed Neurological Deterioration ◽  
Fine Print

✓ The case is reported of a patient who presented with a skull fracture and delayed neurological deterioration due to a cortical arteriovenous fistula at the fracture site. The clinical course and surgical therapy are described. Theories as to the pathogenesis of this lesion as well as a discussion of other intracranial vascular injuries are presented.

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.

Chorea as a manifestation of epidural hematoma

1984 ◽  
Vol 60 (4) ◽  
pp. 856-857 ◽  
Author(s):  
John R. Adler ◽  
Ken R. Winston
Keyword(s):  
Epidural Hematoma ◽  
Content Type ◽  
Fine Print

✓ A child with epidural hematoma presented with choreiform movements which promptly resolved following the evacuation of the hematoma.

Cranioplasty with inner table of bone flap

1985 ◽  
Vol 62 (4) ◽  
pp. 607-609 ◽  
Author(s):  
Kazuhiko Kyoshima ◽  
Hirohiko Gibo ◽  
Shigeaki Kobayashi ◽  
Kenichiro Sugita
Keyword(s):  
Foreign Body Reaction ◽  
Skull Fracture ◽  
Bone Defects ◽  
Skin Incision ◽  
The Body ◽  
Bone Flap ◽  
Growing Skull Fracture ◽  
Content Type ◽  
Additional Exposure ◽  
Fine Print

✓ A new method of cranioplasty is described in which the inner table of the bone flap obtained during craniotomy is used for grafting. The method was used in 10 cases to repair bone defects caused by a growing skull fracture in two, created during removal of an invasive skull tumor in two, during the approach to intraorbital tumors in two, and secondary to craniectomy for additional exposure in four. The method has the advantage that a piece of the inner table for grafting can be obtained from the craniotomy bone flap, without the need for an additional skin incision or taking a graft from another part of the body, and foreign-body reaction is minimal.

Multiple schwannomas: schwannomatosis or neurofibromatosis type 2?

1998 ◽  
Vol 89 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Matti Tapio Seppälä ◽  
Markku Alarik Sainio ◽  
Matti Jouko Johannes Haltia ◽  
Jaakko Jyri Kinnunen ◽  
Kirsi Hannele Setälä ◽  
...  
Keyword(s):  
Clinical Course ◽  
Positive Family History ◽  
Neurofibromatosis Type ◽  
Magnetic Resonance Images ◽  
Neurofibromatosis Type 2 ◽  
Long Term Outcome ◽  
Content Type ◽  
Fine Print

Object. The aim of this study was to clarify the clinical outcome of schwannomatosis, a rare condition characterized by multiple nonvestibular schwannomas in the absence of meningiomas, intraspinal ependymomas, and other clinical signs of neurofibromatosis type 2 (NF2). Methods. Nine patients with schwannomatosis treated at one institution are presented and their clinical course during a median follow-up time of 9.9 years is discussed. The patients were typically middle-aged at the time of their first operation (median 43.5 years), none had a positive family history of schwannomatosis or NF2, and none showed cutaneous or ocular signs of NF2. On histopathological examination the tumors from the patients with schwannomatosis showed a lobular appearance and frequent Verocay bodies, signs indicating NF2, more often than 20 sporadic schwannomas that were investigated as controls. Two patients died of unrelated causes at 3.2 and 9.9 years, respectively, of follow up. Magnetic resonance images of the head and spine were obtained in seven patients at the end of the follow-up period. New spinal schwannomas were detected in one patient and a residual schwannoma in three. No germline mutations of the NF2 gene were found in these seven patients. Two additional patients originally included in the schwannomatosis group who were 8.6 and 11.7 years old at initial surgery had NF2. One was diagnosed at follow-up review and the other developed a fulminant disease that led to death in 4 years. Conclusions. The clinical course, long-term outcome, and genetic mechanism of schwannomatosis differ from that of NF2.

Efficacy of dural tenting sutures

1999 ◽  
Vol 91 (2) ◽  
pp. 180-184 ◽  
Author(s):  
Ken R. Winston
Keyword(s):  
Epidural Hematoma ◽  
Compelling Evidence ◽  
Content Type ◽  
Epidural Bleeding ◽  
Epidural Hemorrhage ◽  
Prophylactic Use ◽  
Intracranial Operation ◽  
Fine Print

Object. The goal of this study was to assess the necessity for the prophylactic use of dural tenting sutures.Methods. Data that had been prospectively collected from 369 consecutive cranial operations in adults were analyzed. In this series of patients, dural tenting sutures were used on a judicious “as needed” basis. They were never used to satisfy a procedural routine or for use as a prophylaxis against epidural hemorrhage that was not apparent. Tenting sutures were used for the control of epidural bleeding in 33 patients (8.9%); no tenting was required in 336 patients (91.1%). Reoperation for postoperative epidural hematoma was not required in this series.Conclusions. Dural tenting sutures continue to have an important role in neurosurgery; however, there is no compelling evidence to support their traditional prophylactic use in every intracranial operation.

Sign in / Sign up

Export Citation Format

Share Document