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.

Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence

2001 ◽  
Vol 95 (2) ◽  
pp. 256-262 ◽  
Author(s):  
Hiroshi Nakaguchi ◽  
Takeo Tanishima ◽  
Norio Yoshimasu
Keyword(s):  
Natural History ◽  
Recurrence Rate ◽  
Postoperative Recurrence ◽  
Cranial Base ◽  
Intracranial Extension ◽  
Content Type ◽  
Subdural Hematomas ◽  
History Of ◽  
Internal Architecture ◽  
Fine Print

Object. Factors affecting the postoperative recurrence of chronic subdural hematomas (CSDHs) have not been sufficiently investigated. The authors have attempted to determine features of CSDHs that are associated with a high or low recurrence rate on the basis of the natural history of these lesions and their intracranial extension. Methods. One hundred six patients (82 men and 24 women) harboring 126 CSDHs who were treated at Tokyo Kosei Nenkin Hospital between January 1989 and April 1998 were studied. Types of CSDHs were classified according to hematoma density and internal architecture, and the intracranial extension of the hematomas were investigated. The postoperative recurrence rate was calculated for each factor. Based on the internal architecture and density of each hematoma, the CSDHs were classified into four types, including homogeneous, laminar, separated, and trabecular types. The recurrence rate associated with the separated type was high, whereas that associated with the trabecular type was low. Chronic subdural hematomas are believed to develop initially as the homogeneous type, after which they sometimes progress to the laminar type. A mature CSDH is represented by the separated stage and the hematoma eventually passes through the trabecular stage during absorption. Based on the intracranial extension of each hematoma, CSDHs were classified into three types, including convexity, cranial base, and interhemispheric types. The recurrence rate of cranial base CSDHs was high and that of convexity CSDHs was low. Conclusions. Classification of CSDHs according to the internal architecture and intracranial extension may be useful for predicting the risk of postoperative recurrence.

scholarly journals Role of histidine 373 in the catalytic activity of coagulation factor XIII.

1994 ◽  
Vol 269 (12) ◽  
pp. 9190-9194
Author(s):  
R. Micanovic ◽  
R. Procyk ◽  
W. Lin ◽  
G.R. Matsueda
Keyword(s):  
Catalytic Activity ◽  
Factor Xiii ◽  
Coagulation Factor ◽  
Coagulation Factor Xiii

Acute subdural hematomas of arterial origin

1974 ◽  
Vol 41 (4) ◽  
pp. 435-439 ◽  
Author(s):  
Paul K. O'Brien ◽  
John W. Norris ◽  
Charles H. Tator
Keyword(s):  
Vessel Wall ◽  
Arterial Wall ◽  
Acute Subdural Hematoma ◽  
Subdural Space ◽  
Small Surface ◽  
Content Type ◽  
Subdural Hematomas ◽  
Arterial Bleeding ◽  
Fine Print

✓ Five cases of acute subdural hematoma associated with bleeding from cortical arteries are described. In the four cases in which the affected vessel was examined histologically, there was a defect in the arterial wall secondary to avulsion of a small surface twig, which had apparently been traversing the subdural space. The possible mechanisms for damage to the vessel wall and the role of this arterial bleeding in subdural hematomas are discussed.

Role of blood coagulation factor XIII in patients with acute pulmonary embolism. Correlation of factor XIII antigen levels with pulmonary occlusion rate, fibrinogen, D-dimer, and clot firmness

2003 ◽  
Vol 90 (09) ◽  
pp. 434-438 ◽  
Author(s):  
Nils Kucher ◽  
Verena Schroeder ◽  
Hans Kohler
Keyword(s):  
Pulmonary Embolism ◽  
Factor Xiii ◽  
Acute Pulmonary Embolism ◽  
Coagulation Factor ◽  
Helical Computed Tomography ◽  
Coagulation Factor Xiii ◽  
A Subunit ◽  
Occlusion Rate ◽  
D Dimer

SummaryIn patients with acute pulmonary embolism (PE), pulmonary occlusion rate is directly related to D-dimer and inversely related to fibrinogen levels. The role of coagulation factor XIII (FXIII) levels in acute venous thromboembolism is not known. A total of 120 consecutive patients with suspected PE and VIDAS D-dimer levels >500 μg/L were investigated by helical computed tomography (CT). Pulmonary occlusion rate was assessed by CT using the modified Miller index. D-dimer, fibrinogen, and FXIII A- and B-subunit antigen levels were taken on admission. Thrombelastography (TEG) was performed in a subset of patients (n=12).The 71 patients with PE had lower FXIII A-subunit levels than the 49 patients with excluded PE (78.6±24.5% vs. 91.3±28.8%, p=0.01). In both groups, FXIII A-subunit was inversely related to D-dimer levels. FXIII A-subunit correlated with fibrinogen levels in patients with PE but not in patients without PE. FXIII A-subunit decreased with increasing pulmonary occlusion rate. The risk of PE was increased in the presence of A-subunit levels < 60% (OR 7.0 [95% CI 1.4-35.3], p=0.019). Clot firmness determined by TEG was lower in patients with PE than in patients without PE.In patients with PE, circulating FXIII A-subunit is decreased compared to patients with suspected but excluded PE. The higher the clot burden within the pulmonary arteries the lower the FXIII antigen. In these patients, direct relation of FXIII A-subunit to fibrinogen levels argues for significant consumption of these coagulation factors in PE. This consumption of FXIII can also be detected by a global coagulation test like TEG.

Growing fracture of the skull and the role of computerized tomography

1981 ◽  
Vol 55 (3) ◽  
pp. 470-472 ◽  
Author(s):  
Richard H. Lye ◽  
J. V. Occleshaw ◽  
John Dutton
Keyword(s):  
Head Injury ◽  
Computerized Tomography ◽  
Case History ◽  
Rare Complication ◽  
Leptomeningeal Cyst ◽  
Content Type ◽  
History Of ◽  
Fine Print

✓ Growing fracture of the skull is a rare complication following head injury. The case history of a child with such a fracture, who developed a leptomeningeal cyst, is presented. The unusual features of this case are discussed in the light of previous reports. The usefulness of computerized tomography in obviating the need for more invasive preoperative investigations is demonstrated.

Interhemispheric subdural hematoma

1984 ◽  
Vol 60 (6) ◽  
pp. 1300-1302 ◽  
Author(s):  
Alan H. Fruin ◽  
Gregory L. Juhl ◽  
Charles Taylon
Keyword(s):  
Natural History ◽  
Conservative Treatment ◽  
Intracranial Hemorrhage ◽  
Subdural Hematoma ◽  
Operative Intervention ◽  
Rare Form ◽  
Content Type ◽  
History Of ◽  
Bridging Veins ◽  
Fine Print

✓ A case of interhemispheric subdural hematoma (ISH) is presented and discussed. This disorder is a rare form of intracranial hemorrhage, which classically presents as an isolated paresis of one leg or a hemiparesis worse in the leg than the arm. The majority of cases are due to occipital trauma because of the anatomy of the bridging veins. Chronic interhemispheric hematomas are rare since the natural history of these lesions is to spread out over the cerebral convexity. Conservative treatment for ISH may be beneficial unless neurological deterioration necessitates early operative intervention.

Eosinophil degranulation in the capsule of chronic subdural hematomas

1985 ◽  
Vol 62 (2) ◽  
pp. 257-260 ◽  
Author(s):  
Tetsumori Yamashima ◽  
Toshihiko Kubota ◽  
Shinjiro Yamamoto
Keyword(s):  
Vascular Wall ◽  
Content Type ◽  
Outer Membranes ◽  
Vascular Lumen ◽  
Subdural Hematomas ◽  
The Matrix ◽  
Granule Matrix ◽  
Fine Print ◽  
Eosinophil Degranulation

✓ A previously unrecognized role of eosinophils in chronic subdural hematomas is described. Outer membranes of hematomas with marked infiltration by eosinophils were studied ultrastructurally with particular attention to the degranulation of these cells. In all of the five cases studied, degranulation was observed. Disintegration of the cells contributed to the release of granules. The free granules, the matrix of which has been demonstrated to contain plasminogen, were often circulating in the vascular lumen and trapped among the aggregated platelets. They were also found within the fragile vascular wall surrounded by fibrinoid material and in the edematous perivascular interstitium. Some of the perivascular eosinophils showed frank solubilization of granule matrix contents in spite of unaltered crystalloids. These findings suggest a role of eosinophils in the development of local hyperfibrinolysis within the outer membranes, which might contribute to the fluidity of chronic subdural hematomas and the resultant leakage of blood from the vessels in the capsules.

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