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Chronic subdural hematoma  

Science.gov (United States)

Subdural hemorrhage - chronic; Subdural hematoma - chronic; Subdural hygroma ... A subdural hematoma develops when the tiny veins that run between the dura and surface of the brain (bridging veins) tear ...

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Chronic subdural hematoma  

International Nuclear Information System (INIS)

Recently much attention has been paid once again to etiology of chronic subdural hematoma since the appearance of computed tomography (CT). Authors examined 1824 head injury cases by CT from January 1977 to September 1979. Among them, there are 40 cases (they were all over 16 years old) whose CT showed frontal extracerebral low density area. The low density area which is considered to be so-called fluid collection could be classified into four types (type I to IV). In two cases of those 40 cases (5%), the low density area changed into high density area which seemed to be hemorrhage. The 2 cases were diagnosed to be chronic subdural hematoma and proved surgery. The change of density on CT developed only from type I (the brain surface looks smooth and sulci are not recognized beneath the low density area). The change of density, occurred in 2 cases among 24 cases of type I (8.3%), was recognized about 2 months after the head injury. This fact is compatible with the report by Yamada et al. (1979). Thus, when CT after the head injury shows frontal extracerebral low density area of type I, the case may develop to chronic subdural hematoma about 2 months after the head injury. Therefore, careful observation should be needed especially during this period after the head injury. (author)

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Pathogenesis of chronic subdural hematoma  

International Nuclear Information System (INIS)

Ten cases of chronic subdural hematoma that were followed by a sequential study with CT from an early posttraumatic period to evolution of chronic subdural hematoma were reported. In four of these 10 cases, the initial CT showed thin subdural collections of high density suggesting acute subdural hematoma. Two weeks later, the density of subdural collections reduced, but their volumes increased. Clinical symptoms such as headache and disorientation occurred three or four weeks later. Preoperative CT showed similar huge subdural collections of low density and marked mass effect. These cases underwent surgery from 24 to 44 days after injury, and development of neomenbranes was confirmed. In the remaining six cases, the initial CT showed thin subdural collections of low density suggesting subdural hygroma. In five of the six cases, the density of the subdural collections was slightly higher than that of cerebrospinal fluid, and in one case, an area of spotted high density was shown. It was suggested that these were mixtures with blood. Follow-up CT scans revealed that the subdural collections increased in size but remained at a uniformly low density for the first month after the head injury, and then the increase in density occurred. Operations were performed 55 to 76 days after injury, and operative findings were not different from those of common chronic subdural hematoma. From these investigations, it was suggested that there were two types of evolution of chronic subdere two types of evolution of chronic subdural hematoma. One is the development from acute subdural hematomas, and the other from subdural hygromas. It is supposed that blood and cerebrospinal fluid are very important factors in the evolution of subdural collections into chronic subdural hematomas. (J.P.N.)

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Contralateral development of chronic subdural hematoma after evacuation of chronic subdural hematoma. A case report.  

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Contralateral acute complications such as acute epi/subdural hematomas can be encountered after evacuation of a chronic subdural hematoma, though they are rare. We found only one case of chronic subdural hematoma following the surgery for contralateral chronic subdural hematoma, have been published in English language literature. A 73-year-old male admitted to our hospital with a right-sided subdural hematoma. The subdural hematoma was evacuated through a burr-hole. A left-sided subdural higroma appeared after operation and turned into classical subdural hematoma in the course of time. After evacuation of contralateral chronic subdural hematoma, the patient recovered completely. All stages of the development of contralateral chronic subdural hematomas were shown by serial computed tomograms. It was suggested that traumatic chronic subdural hematomas develop from mostly subdural higromas. If contralateral subdural higroma is seen after surgical evacuation of a chronic subdural hematoma, the possibility of development of contralateral chronic subdural hematoma must be kept on mind. PMID:17019388

Sucu, H Kamil; Gökmen, M; Bezircioglu, H; Tekta?, S

2006-09-01

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Postoperative course of chronic subdural hematoma  

International Nuclear Information System (INIS)

1) Fourty cases of chronic subdural hematoma were operated on by trephination, irrigation and external drainage. Postoperative neurological recovery and decrease of hematoma cavity on CT scan were followed. 2) Operation were effective for recovery of neurological grade in 28 cases, moderately effective in 7 cases and not effective in 5 cases. 3) Withinthe tenth postoperative day, more than half residual hematoma cavity existed in 53% of examined cases. After that, more than half residual cavity existed in only 17%. 4) Preoperative feature of neurologically unimproved cases were no definite history of head trauma and water like low density of hematoma cavity. Postoperative feature was persistence of more than three fourth of residual hematoma cavity on CT scan. 5) A group of unimproved cases described above are thought to have a feature of subdural hygroma rather than subdural hematoma. When possibility of subdural hygroma is high in preoperative differential diagnosis, indication of operation should be different from chronic subdural hematoma. (author)

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Chronic subdural hematoma secondary to traumatic subdural hygroma  

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Sometimes chronic subdural hematoma can be developed following posttraumatic subdural hygroma. The purpose of this study is to investigate its incidence, the duration required for their conversion, and characteristic CT and MR findings of subdural hygroma and chronic subdural hamatoma. We studied 8 patients with persistent posttraumatic subdural hygroma which consequently developed chronic subdural hamatoma. The patients were examined with CT initially and followed-up with CT in 3 and MR in 5. We analyzed the location of the lesion, the change of the density or signal intensity, the change of the size, and the degree of enhancement and mass effect. The duration required for the formation of hematoma was 48-166 days (mean, 76 days). The characteristic CT findings of subdural hygroma were a crescentric lesion with CSF density along the inner table with-out contrast enhancement. The mass effect was minimal. The CT findings of chronic subdural hematoma were higher density than that of hygroma in all cases, increase in thickness and size in 3 cases, and contrast enhancement along the inner membrane of the hematoma in 5 cases. The signal intensities of the subdural hygroma were identical to those of CSF on both T1 and T2 weighted images, whereas, those of chronic subdural hamatoma were higher. The increased signal intensity on T1 weighted MR images and increased attenuation or contrast enhancement of the lesion on CT may suggest the conversion of subdural hygroma into chron conversion of subdural hygroma into chronic subdural hematoma

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Computerized tomography in chronic subdural hematoma  

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In this report, the computerized tomography (CT) of chronic subdural hematoma was studied. Our experience was based on 22 patients with chronic subdural hematoma, verified by surgery. The results of the analysis of 16 cases excluded infant cases and post-operative cases. (1) In 8 cases, the locations of the hematoma were bilateral, and in 8 cases, unilateral. (2) The CT findings of the hematomas were classified into 4 types: low density (9 cases), iso-density (2 cases), mixed density (2 cases), and high density (3 cases). (3) Contrast enhancement in the capsule and the content of hematoma was indicated by the Marginal Curve. In infant cases (4), it is difficult to diagnose by the CT scan alone. We concluded, however, that CT was very useful in diagnosing chronic subdural hematoma. (author)

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Cortical enhancement in chronic subdural hematoma  

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In the CT findings of chronic subdural hematoma, brain enhancement adjacent to a subdural hematoma was seen occasionally after the injection of a contrast material. The authors called this finding ''cortical enhancement'', and 35 cases of chronic subdural hematoma were studied concerning cortical enhancement in relation to age, clinical signs and symptoms, hematoma density, and volume of the hematoma. Eight cases out of the 35 were subjected to measurements of the regional cerebral blood flow preoperatively by the method of the carotid injection of Xe-133. Cortical enhancement was apt to be seen in the cases which revealed intracranial hypertension or disturbance of consciousness, in isodensity or mixed-density hematomas, and in huge subdural hematomas. There was no specific correlation with age distribution. The pathogenesis of cortical enhancement seemed to be the result of cerebral compression with an increase in the contrast material per unit of volume and a prolonged venous outflow from the hemisphere, but no characteristic feature was detected in the average regional cerebral blood flow in our cases. (author)

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Chronic Subdural Hematoma Following Electro Convulsive Therapy  

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Subdural hematoma is a rare but serious complication following electroconvulsive therapy (ECT), a frequently used treatment modality in the management of various psychiatric morbidities including bipolar affective disorder (BAD). There are very few reports of intracranial bleeding following ECT in the literature. A 38-year-old female, known case of BAD for last fifteen years receiving ECT, presented with the symptoms of dysphasia, headache, left sided paresis, and sudden deterioration of sensorium. Computed tomography (CT) scan of the brain was suggestive of left-sided fronto parietal chronic subdural hematoma with midline shift that was drained successfully. PMID:23162198

Saha, Debasish; Bisui, Bikash; Thakurta, Rajarshi Guha; Ghoshmaulik, Sumanta; Singh, Om Prakash

2012-01-01

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Acute-on-chronic subdural hematoma by spinal anesthesia in a patient with undiagnosed chronic subdural hematoma -A case report-  

OpenAIRE

Subdural hematoma is a serious but rare complication of spinal anesthesia. A 70-year-old woman patient underwent elective total knee replacement under spinal anesthesia. At 4 days postoperatively, the patient complained of headache and vomiting. Brain computed tomography revealed an acute-on-chronic subdural hematoma with midline shift. The patient recovered completely after surgical decompression. We report a patient with an undiagnosed chronic subdural hematoma, who developed acute-on-chron...

Park, Il Bong; Moon, Soo Yeong; Kim, Yu Yil; Kwon, Young Eun; Lee, Jun Hak

2011-01-01

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Nonsurgical treatment of chronic subdural hematoma  

International Nuclear Information System (INIS)

Sequential changes of clinical symptoms and computed tomography (CT) scans were investigated in 20 patients of chronic subdural hematoma treated by osmotherapy utilizing intravenous 20 % mannitol 1,000 ml daily for 2 weeks. Plain, contrast enhancement, and 4-hour-delayed contrast enhancement CT scans were taken once every week for 4 weeks from the start of the treatment and then once every month until hematoma disappeared. Though the clinical symptoms aggravated slightly in 4 cases during the first or second week, all the cases became asymptomatic at the end of the treatment and showed no recurrence thereafter. Sequential changes in CT scans are summarized as follows. 1) Plain CT scans showed that the hematoma started to reduce in size rapidly after termination of the treatment. Density of hematoma decreased sequentially, although it increased transiently in 9 cases. After treatment, the hematoma disappeared after 3 months in 18 cases, after 4 months in one case, and 5 months in one case. 2) In contrast enhancement CT, two types of contrast enhancement were observed: ribbon-like cortical enhancement and linear enhancement beneath the hematoma. These enhancement effects were seen in 80 % of cases (cortical enhancement in 70 %, linear enhancement in 10 %) before the treatment. The cortical enhancement decreased through the treatment and disappeared in 2 months after the treatment. 3) The contrast enhancement effects within the hematoma cavity (evaluated as the relative ematoma cavity (evaluated as the relative increase of the CT numbers in the 4-hour-delayed contrast enhancement CT scans) were closely related to the hematoma reduction rate; the more marked and lasting the enhancement effects, the more delayed was the hematoma to be reduced by osmotherapy. (J.P.N.)

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Analysis of chronic subdural hematoma based on CT, (2)  

International Nuclear Information System (INIS)

Twenty-three cases of chronic subdural hematoma were observed soon after head injury for the relationship between its CT findings and clinical symptoms. It has been found that the chronic subdural hematoma is a slowly growing and expanding intracranial disease that starts in an early period of head injury. Chronic subdural hematoma did not present any signs or symptoms initially, except for the gradual occurrence of headache, but finally it presented signs of intracranial hypertension and focal signs. Chronic subdural hematoma in the hygroma-like period did not show any signs and symptoms. In the capsulated period, when changes in CT density suggested intracapsular hemorrhage, a heavy sensation of the head was noted. It was recognized as an abnormal feeling or a full sensation of the head. When the bleeding continued in the cavity, headache became continuous and focal signs gradually appeared. (author)

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Traumatic Subdural Effusion Evolving into Chronic Subdural Hematoma  

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Full Text Available Background: Chronic subdural hematoma (CSDH is a common complication in head injuries. The objective of this study is to establish the evolution of traumatic subdural effusion (TSDE into CSDH using clinical signs and symptoms as well as radiology. Our aim is to effectively manage such cases without postoperative recurrence (PR. Methodology: The study was a retrospective cohort carried out in the No. 1 People’s Hospital of Jingzhou from August 2007 to November 2013. The hospital is affiliated to the Yangtze University. All the patients included in this study were involved in road traffic accidents and sustained various degree of head injury. Serial CT scans were done to establish the development TSDE and the evolution of the TSDE into CSDH and treatment options. Results: In all 159 patients developed TSDE and out of these 34 which constitute 21.38% had their TSDE evolving into CSDH. Most of the patients were elderly. Twelve patients were treated conservatively while the remaining patients were treated surgically by drilling and drainage of hematoma. All the patients survived with marked improvement in their sign and symptoms with no recurrence. Conclusion: TSDE is one of the etiological factors for the development of CSDH in the elderly although in most cases the etiology of CSDH is usual multifactory. It must be stated clearly that, the evolution of TSDE into CSDH is initially a hidden process and presents with nonspecific signs and symptoms which can easily be missed. CT scan is usually the initial radiology of choice in making diagnosis of TSDE but MRI could be used to make early diagnosis of the transgression of TSDE into CSDH, and hence early surgical intervention before the formation of a neomembrane could reduce PR rate.

Seidu A. Richard

2014-12-01

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Chronic subdural hematoma infected by propionibacterium acnes: a case report.  

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We present a very rare case of a patient with an infected subdural hematoma due to Propionibacterium acnes. A 63-year-old male complained of dizziness and was admitted to our hospital. He had a history of left chronic subdural hematoma due to a traffic accident, which had been conservatively treated. Physical, neurological and laboratory examinations revealed no definite abnormality. Plain CT scan demonstrated a hypodense crescentic fluid collection over the surface of the left cerebral hemisphere. The patient was diagnosed with chronic subdural hematoma and underwent burr hole surgery three times and selective embolization of the middle meningeal artery, but the lesion easily recurred. Repeated culture examinations of white sedimentation detected P. acnes. Therefore, he underwent craniotomy surgery followed by intravenous administration of antibiotics. The infected subdural hematoma was covered with a thick, yellowish outer membrane, and the large volume of pus and hematoma was removed. However, the lesion recurred again and a low-density area developed in the left frontal lobe. Craniotomy surgery was performed a second time, and two Penrose drainages were put in both the epidural and subdural spaces. Subsequently, the lesions completely resolved and he was discharged without any neurological deficits. Infected subdural hematoma may be refractory to burr hole surgery or craniotomy alone, in which case aggressive treatment with craniotomy and continuous drainage should be indicated before the brain parenchyma suffers irreversible damage. PMID:25759659

Yamamoto, Shusuke; Asahi, Takashi; Akioka, Naoki; Kashiwazaki, Daina; Kuwayama, Naoya; Kuroda, Satoshi

2015-01-01

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Benefits of Artcereb on the irrigation of chronic subdural hematoma  

International Nuclear Information System (INIS)

Chronic subdural hematoma is thought to be an easily treatable disease. However, its recurrence rate is approximately 10%, and such cases require re-operation. We compared the recurrance rate of chronic subdural hematoma with irrigation using either saline or the artificial cerebrospinal fluid Artcereb. We divided the patients into 2 groups. A total of 60 patients in the normal saline group (hematoma, n=58; bilateral hematoma, n=2) underwent irrigation with saline between March 2007 and July 2009. A total of 61 patients in the Artcereb group (hematoma, n=54; bilateral hematoma, n=7) underwent irrigation using Artcereb between August 2009 and May 2011. We performed irrigation via 1 burr hole with 500-1000 ml of either normal saline or Artcereb under local anesthesia and observed until recurrence or disappearance of the hematomas on CT scan. We researched the recurrence rate of the hematomas. Recurrence of the hematomas were observed in 8 cases (13%) in the normal saline group and 5 cases (8.2%) in the Artcereb group. No statistically significant differences were observed. Among those patients who did not receive anticoagulants, the recurrence rate was 6/54 (11%) in the normal saline group and 1/49 (2.0%) in the Artcereb group (p<0.10). Our study showed the possibility that the postoperative recurrence rate of chronic subdural hematoma was lower using Artcereb than saline for irrigation. (author)

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[Infected subdural hematoma having a surgery of chronic subdural hematoma 1 year ago:a case report].  

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We report a case of an infected subdural hematoma that occurred 1 year after burr-hole irrigation for chronic subdural hematoma. A 78-year-old woman who had developed left hemiparesis was admitted to our hospital. A computed tomography(CT)scan revealed the presence of a chronic subdural hematoma in the right hemisphere. Her clinical symptoms improved immediately after emergency burr-hole irrigation, which allowed her discharge from the hospital. One year after the initial surgery, she developed an infection of the urinary tract infection, which led to severe pyelonephritis and septic shock. Treatment of the urological symptoms eliminated the systemic inflammation. One month after the urinary infection, the patient was readmitted to the hospital in a comatose state. A CT scan showed regrowth of a residual subdural hematoma surrounded by a thick capsule, causing a midline shift in the brain. An emergency operation for removal of the subdural hematoma by burr-hole irrigation was performed, and pus was drained from the subdural mass. Microbiological cultures of the abscess revealed the presence of Proteus mirabilis. After surgery, the patient was administered an antibiotic treatment for three weeks and she was discharged with no neurological deficits. Cultures of blood from the septic shock as well as from the abscess both revealed the presence of Proteus mirabilis. Therefore, a diagnosis of infected subdural hematoma, which was caused by hematogenous infection, was made. We conclude that attention should be paid to the risk of infection of the hematoma capsule in subdural hematomas. PMID:25672558

Nagao, Takaaki; Miyazaki, Chikao; Ando, Shunpei; Haga, Daisuke; Kuroki, Takao; Sugo, Nobuo; Nagao, Takeki

2015-02-01

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Chronic calcified subdural hematoma: Case report and review of the literature  

OpenAIRE

Background: Calcified chronic subdural hematoma is a rare but known entity, estimated to represent 0.3-2.7% of chronic subdural hematomas. Although surgical treatment is unanimous for chronic subdural hematomas, therein lies some doubt on it being applied to calcified chronic subdural hematomas. Case Description: We report a case of a 73?year?old male, presenting with deterioration of motor function in his right limbs since 18 months, with computed tomography (CT) scans and...

Pappamikail, L.; Rato, R.; Novais, G.; Bernardo, E.

2013-01-01

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Tratamiento médico de un hematoma subdural crónico / Medical treatment of a chronic subdural hematoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta una paciente portadora de un hematoma subdural crónico postraumático, que se trató médicamente y se logró su desaparición en el curso de varios meses, sin tratamiento quirúrgico y sin signos evolutivos de empeoramiento neurológico. La furosemida fue usada como medicamento básico en su tr [...] atamiento. Se adjuntan imágenes que confirman el valor de este punto de vista terapéutico. Abstract in english This is the case of a patient carrier of a post-traumatic chronic subdural hematoma clinically treated achieving its disappearance over some months without surgical treatment and evolutionary signs of neurologic worsening. The furosemide was used as basic drug in its treatment. The images confirming [...] the value of this point of therapeutical view are enclosed.

Antonio, Guevara Melcón; Ashley, Obregón Marín.

2012-03-01

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Metrizamide CT cisternography in cases of traumatic subdural hygroma and chronic subdural hematoma  

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Subdural fluid collection and some cases of chronic subdural hematoma are observed by means of a CT scan as marginal low-density areas (m-LDA) in head-injured patients. It is thought that the cerebro-spinal fluid dynamics may play an important role in the pathogenesis and clinical course of such subdural pathology. We applied metrizamide CT cisternography to these cases. According to the findings of this metrizamide CT cisternography (M-CTC), the examples of subdural pathology can be classified into four types: Type I: Metrizamide filling is seen in both the cortical subarachnoid space and the m-LDA. Type II: Metrizamide filling is seen only in the cortical subarachnoid space, not in the m-LDA. Type III: Metrizamide filling is very poor in both the cortical subarachnoid space and the m-LDA. Type IV: Metrizamide filling extends well into the m-LDA, but only partially into the cortical subarachnoid space. Many of these cases studied had been operated on and the subdural pathology had been ascertained. From a comparison between the M-CTC and subdural types of pathology, subdural pathology of Types I, II, and III can all be classified as cases of a subdural hygroma (subdural fluid collection or subdural effusion), while Type IV is a chronic subdural hematoma. The characteristics and choice of treatment of each type may be briefly shown as follows: For Type I conservative therapy is recommended because of its tendency to decrease rapidly. For Type II a subduro-peritoneal shunt is recommended, for the m-LDA is long-standing and a simple burrhole evacuation sometimes results in an aggravation of the subdural hygroma. For Type III a burrhole evacuation is recommended; also, care must be taken against the development of a chronic subdural hematoma. For Type IV a burrhole evacuation is recommended became such cases are all chronic subdural hematoma. (J.P.N.).

Morimoto, Tetsuya; Takemura, Kiyoshi; Inui, Shoji; Hori, Yutaka; Sakaki, Toshisuke; Miyamoto, Seiji; Kyoi, Kikuo; Utsumi, Shozaburo

1987-06-01

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Chronic subdural hematoma fluid and its computerized tomographic density  

International Nuclear Information System (INIS)

Laboratory and in vivo CT analysis were performed on 19 chronic subdural hematomas and five subdural hygromas. In these 25 hematoma samples, red blood cells (RBC), hematocrit, and hemoglobin (Hgb) varied greatly, though, these values correlated well with the CT densities. Plasma protein content was fairly constant with an average of 7.1+-0.8g/dl. There were four hematoma samples with RBC of less than 20x104?l or Hgb of less than 2.0g/dl. Their CT values ranged between 18 and 23 H.U., which were considered close to the in vivo serum level CT density. Five hygroma fluid showed no RBC and very little protein content of less than 0.4g/dl. CT density ranged between -2 and 13 H.U. The edge effect of the skull was experimentally studied using a phantom skull filled with water. This revealed a remarkable overshoot of the CT values within ten pixels from the inner wall of the skull. Visual observation of the original CT pictures revealed four low density hematomas and seven mixed density ones. When compared to the density of the ventricular cavity, all of the low density hematomas and the supernatant part of the mixed density ones were clearly higher in density. All five hygromas appeared CSF dense or lower. In conclusion, because of the edge effect by the skull, thin subdural fluids could not be diagnosed by CT alone. Thick subdural fluids could be differentiated as either hematoma or hygroma by their CT densities. Subdural hematomas had in vivo CT densities of at hematomas had in vivo CT densities of at least serum level or approximately 20 H.U., while subdural hygromas had densities close to CSF. These characteristics were best appreciated by visual observation of the CT scan films. (J.P.N.)

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Chronic spinal subdural hematoma; Spinales chronisches subdurales Haematom  

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Compared with spinal epidural hematomas, spinal subdural hematomas are rare; chronic forms are even more uncommon. These hematomas are associated not only with lumbar puncture and spinal trauma, but also with coagulopathies, vascular malformations and tumors. Compression of the spinal cord and the cauda equina means that the patients develop increasing back or radicular pain, followed by paraparesis and bladder and bowel paralysis, so that in most cases surgical decompression is carried out. On magnetic resonance imaging these hematomas present as thoracic or lumbar subdural masses, their signal intensity varying with the age of the hematoma. We report the clinical course and the findings revealed by imaging that led to the diagnosis in three cases of chronic spinal subdural hematoma. (orig.) [German] Spinale subdurale Haematome sind im Vergleich zu epiduralen Haematomen selten, chronische Verlaufsformen noch seltener. Ursaechlich sind neben Lumbalpunktionen und traumatischen Verletzungen auch Blutgerinnungsstoerungen, Gefaessmalformationen und Tumoren. Aufgrund der Kompression von Myelon und Cauda equina kommt es zu zunehmenden Ruecken- oder radikulaeren Schmerzen mit anschliessender Paraparese sowie einer Darm- und Blasenstoerung, weshalb in den meisten Faellen eine operative Entlastung durchgefuehrt wird. Magnetresonanztomographisch stellen sich die Haematome meist als thorakale bzw. lumbale subdurale Raumforderungen dar, die Signalintensitaet variiert mit dem Blutungsalter. Wir berichten ueber den klinischen Verlauf und die bildgebende Diagnostik von 3 Patienten mit spinalen chronischen subduralen Haematomen. (orig.)

Hagen, T.; Lensch, T. [Radiologengemeinschaft, Augsburg (Germany)

2008-10-15

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Primary enlarged craniotomy in organized chronic subdural hematomas.  

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The aim of the study is to evaluate the efficacy of craniotomy and membranectomy as initial treatment of organized chronic subdural hematoma (OCSH). We retrospectively reviewed a series of 34 consecutive patients suffering from OCSH, diagnosed by magnetic resonance imaging (MRI) or contrast computer tomography (CCT) in order to establish the degree of organization and determine the intrahematomal architecture. The indication to perform a primary enlarged craniotomy as initial treatment for non-liquefied chronic subdural hematoma (CSDH) with multilayer loculations was based on the hematoma MRI appearance--mostly hyperintense in both T1- and T2-weighted images with a hypointense web- or net-like structure within the hematoma cavity. The reason why some hematomas evolve towards a complex and organized architecture remains unclear; the most common aspect to come to light was the "long standing" of the CSDHs which, in our series, had an average interval of 10 weeks between head injury and initial scan. Recurrence was found to have occurred in 2 patients (6% of cases) in the form of acute subdural hematoma. One patient died as the result of an intraventricular and subarachnoid haemorrhage, while 2 patients (6%) suffered an haemorrhagic stroke ipsilateral to the OCSH. Eighty-nine percent of cases had a good recovery, while 11% remained unchanged or worsened. In select cases, based on the MRI appearance, primary enlarged craniotomy seems to be the treatment of choice for achieving a complete recovery and a reduced recurrence rate in OCSH. PMID:24305027

Callovini, Giorgio Maria; Bolognini, Andrea; Callovini, Gemma; Gammone, Vincenzo

2014-01-01

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Initial hematoma pressure and clinical recurrence of chronic subdural hematoma in cases where percutaneous subdural tapping was performed  

International Nuclear Information System (INIS)

Percutaneous subdural tapping for chronic subdural hematoma (CSDH) can measure initial hematoma pressure, which cannot be measured using burr-hole craniotomy. Initial hematoma pressure has not been discussed as a risk factor for recurrence. We evaluated the clinical features for recurrence, which included initial hematoma pressure. The study involved 71 unilateral CSDH cases whose initial hematoma pressure was measured using percutaneous subdural tapping. Clinical recurrence was identified in 19 cases (23%). Age, sex, neurological grading, alcohol consumption, presence of head injury, hypertension, diabetes mellitus, antiplatelet, anticoagulant medication, hematoma volume on computed tomography (CT) images, and initial hematoma pressure were compared between non-recurrence and recurrence groups. The initial hematoma pressure was 12.6±4.5 cmH2O in the non-recurrence group, and 15.5±6.2 cmH2O in the recurrence group (p<0.05). The other factors did not differ significantly except hematoma volume on CT images (92±45 ml in the non-recurrence group and 123±43 ml in the recurrence group, p<0.05). Cases with high initial hematoma pressure should be closely observed. (author)

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Spontaneous acute subdural hematoma and chronic epidural hematoma in a child with F XIII deficiency.  

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Factor XIII (F XIII) deficiency is a rare autosomal recessive congenital disorder that can cause spontaneous subdural or epidural hematomas. Due to its low incidence, F XIII deficiency may well be under-diagnosed. A 7-year-old girl with no history of medical problems presented with progressive headache of 3 days. Cerebral computed tomography (CT) scans revealed a large right acute parietooccipital subdural hematoma with a significant midline shift. After an emergent parietooccipital craniotomy and evacuation of the subdural hematoma, a screening test for factor XIII was performed. The results of the test were abnormal. She had full recovery and was discharged with a follow-up treatment of monthly transfusion of fresh frozen plasma as the replacement and prophylactic therapy. Ten months later, she was referred to our center with headache after a minor head trauma. Her medical history revealed that she had not received fresh frozen plasma for the last 2 months. CT scan showed a chronic right parietal epidural hematoma beneath the craniotomy flap. The present case indicates that although its incidence is very rare, F XIII deficiency can cause acute or chronic subdural and epidural hematomas. Therefore, in acute or chronic subdural and epidural hematomas with no underlying cause, the presence of a potential F XIII deficiency should be suspected as a cause of hemorrhagic diathesis. PMID:18514462

Vural, Murat; Yarar, Coskun; Durmaz, Ramazan; Atasoy, Metin Ant

2010-01-01

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PATOBIOLOGÍA DEL HEMATOMA SUBDURAL CRÓNICO.  

OpenAIRE

Treatment of subdural cronic hematoma in all ages is a therapeutic challenge. Chronic subdural hematoma is a disease that can be fatal without surgical treatment. A variety of treatment options like subdural tapping, endoscopic washout, shunting and craniotomy have been discussed. In chronic subdural hematoma, spontaneous resolution with conservative treatment is not an common therapeutic method because it has causes high mortality, requires long periods of time, and finally, many patients ne...

Rubén Sabogal Barrios; Luís Rafael Moscote Salazar

2008-01-01

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PATOBIOLOGÍA DEL HEMATOMA SUBDURAL CRÓNICO.  

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Full Text Available Treatment of subdural cronic hematoma in all ages is a therapeutic challenge. Chronic subdural hematoma is a disease that can be fatal without surgical treatment. A variety of treatment options like subdural tapping, endoscopic washout, shunting and craniotomy have been discussed. In chronic subdural hematoma, spontaneous resolution with conservative treatment is not an common therapeutic method because it has causes high mortality, requires long periods of time, and finally, many patients need surgical treatment. The etiology, physiopathology and surgical alternatives in the treatment of subdural chronic hematoma is discussed.

Rubén Sabogal Barrios

2008-01-01

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Subdural hyperintense band on diffusion-weighted imaging of chronic subdural hematoma indicates bleeding from the outer membrane  

International Nuclear Information System (INIS)

The diffusion-weighted magnetic resonance (MR) imaging characteristics of chronic subdural hematoma and the correlation between hematoma liquidity and apparent diffusion coefficient (ADC) were investigated in 26 consecutive patients, 16 males and 10 females aged 42 to 92 years (mean±SD 73.3±13.1 years), with 31 chronic subdural hematomas. The chronic subdural hematomas were divided into homogeneous, separate, and trabecular types based on diffusion-weighted MR imaging findings. Almost all hematomas were low intensity on diffusion-weighted imaging, and the mean ADC value was 1.81±0.79 x 10-3 mm2/sec. The high intensity areas in the subdural hematomas consisted of several types: high intensity line along the dura mater (subdural hyperintense band), high intensity along the intrahematoma septum, and laminar shape along the inner membrane. The subdural hyperintense bands accounted for almost all high intensity areas in the subdural hematomas. The mean ADC value of the high intensity areas was 0.76±0.24 x 10-3 mm2/sec, close to that of the normal brain. The subdural hyperintense bands were considered to be intracellular and/or extracellular methemoglobin based on the T1- and T2-weighted imaging and intraoperative findings. The subdural hyperintense band is an important finding indicating relatively fresh bleeding from the outer membrane. Diffusion-weighted imaging shows liquid subdural hematoma as low inows liquid subdural hematoma as low intensity, and measurement of the ADC values can differentiate between liquid and solid components of the chronic subdural hematoma. (author)

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The question is whether hemiparesis is more common in unilateral than bilateral chronic subdural hematoma  

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Full Text Available Introduction. Chronic subdural hematoma is an intracranial hemorrhagic lesion that illustrates various expressions in clinical and radiological practice. The aim of this study was to emphasize the correlation between the brain site of chronic subdural hematoma and clinical symptoms/signs of disease. Furthermore, the study denotes the significance of hemiparesis occurrence in the patients with unilateral chronic subdural hematomas more than in those with bilateral ones, associated with time required to diagnose hematoma. Material and Methods: A three-year study included 72 patients with chronic subdural hematoma. According to their clinical and neurological symptoms on hospital admission, all patients underwent non-contrast brain computed tomography scan, which confirmed the diagnosis. The radiological parameters, inlcuding the site of chronic subdural hematoma, a hematoma width and midline shift were recorded to give precise data about the correlation with neurological symptoms. A special focus was put on the lag time between the onset of symptoms and signs to diagnosis of chronic subdural hematoma. Results. The study proved that the patients with unilateral chronic subdural hematoma had more frequent occurrence of hemiparesis than the patients with bilateral chronic subdural hematoma. It took the left-sided chronic subdural hematomas less time (about 200 hours earlier than the rightsided ones to present its symptoms although the average hematoma diameter value was almost the same. Conclusion. The site and the form of intracranial lesion-chronic subdural hematoma could have a great influence on neurological and functional condition in a patient. Although the length of time required for making diagnosis as well as clinical symptoms greatly differ and the latter are not always so clear, physicians should maintain a high level of suspicion for this disease and thus contribute to prompt diagnosis and better clinical outcome of patients.

Jukovi? Mirela

2014-01-01

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Moving the Blood and Transforming Stasis for Chronic Subdural Hematoma  

OpenAIRE

A 44-year-old female fainted when she went to the bathroom at midnight. There was abruise over her right cheek when she regained consciousness. The patient had no headacheor neurological defects on physical examination. The computed tomographic (CT) scan ofthe brain showed a chronic subdural hematoma over the right fronto-parietal lobe 12 weeksafter the fainting episode. She took a modification of xu?e f?u zhú y¯u t¯ang ( , XZT,House of Blood Stasis-Expelling Decoction) for moving the bl...

Liang-In Liu; Helen Chang; Lung Chan

2006-01-01

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Quantitative estimation of hemorrhage in chronic subdural hematoma using the 51Cr erythrocyte labeling method  

International Nuclear Information System (INIS)

Red cell survival studies using an infusion of chromium-51-labeled erythrocytes were performed to quantitatively estimate hemorrhage in the chronic subdural hematoma cavity of 50 patients. The amount of hemorrhage was determined during craniotomy. Between 6 and 24 hours after infusion of the labeled red cells, hemorrhage accounted for a mean of 6.7% of the hematoma content, indicating continuous or intermittent hemorrhage into the cavity. The clinical state of the patients and the density of the chronic subdural hematoma on computerized tomography scans were related to the amount of hemorrhage. Chronic subdural hematomas with a greater amount of hemorrhage frequently consisted of clots rather than fluid

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Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma.  

Czech Academy of Sciences Publication Activity Database

Ro?. 61, ?. 2 (2012), s. 161-167. ISSN 0862-8408 Grant ostatní: GA MZd(CZ) NS9794 Institutional research plan: CEZ:AV0Z10300504 Keywords : hypopituitarism * subdural hematoma * brain injury * growth hormone deficiency Subject RIV: ED - Physiology Impact factor: 1.531, year: 2012

Hána, V.; Kosák, M.; Masopust, V.; Netuka, D.; Lacinová, Z.; Kršek, M.; Marek, J.; Pecen, Ladislav

2012-01-01

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Chronic subdural hematoma associated with an arachnoid cyst in a juvenile taekwondo athlete: a case report and review of the literature.  

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Both chronic subdural hematoma and arachnoid cysts are common lesions in neurosurgical practice. Arachnoid cysts are a well-known predisposing factor for chronic subdural hematoma. Here, we present a 12-year-old taekwondo athlete with chronic subdural hematoma associated with arachnoid cysts. The chronic subdural hematoma was evacuated through 2 burr holes and the patient was discharged in good condition. To our knowledge, this is the first case of chronic subdural hematoma with associated arachnoid cysts in a taekwondo athlete. We also review the literature on sports-related chronic subdural hematomas associated with arachnoid cysts in children. PMID:22832284

Kertmen, Hayri; Gürer, Bora; Yilmaz, Erdal Resit; Sekerci, Zeki

2012-01-01

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The classification and clinical course of chronic subdural hematoma on CT scan  

International Nuclear Information System (INIS)

Forty-five cases of chronic subdural hematoma were classified into four groups according to CT findings, mainly by x-ray attenuation, and the relations with clinical findings and physical examinations were studied. The following results were obtained. First group (13 cases): The hematoma shows low attenuated mass effects homogeneously in the subdural territory on CT scan. This type of hematoma was located on the bilateral convexity in about half of the cases. Second group (12 cases): The hematoma of this group revealed two different attenuations in same hematoma, for example, low density and high density, and this group was named the mixed type. Third group (14 cases): The hematoma of this group is difficult to diagnose because of its unclear border with the brain. This was named the iso density type or brain density type. This type of hematoma was generally found in young adults and was huge. than other types. Fourth group (6 cases): The hematoma shows a high density x-ray attenuation of 25 or more Hounsfield units, and was named the high density type. The low density type and isodensity hematoma were thought to be primary stages in its development. The high density type is the terminal stage of the life cycle of chronic subdural hematoma. (author)

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Contralateral acute subdural hematoma occurring after evacuation of subdural hematoma with coexistent contralateral subdural hygroma.  

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Burr-hole craniostomy with closed-system drainage is a safe and effective method for the management of chronic subdural hematoma. However, contralateral acute subdural hematoma has been reported to be a rare and devastating complication. Only 3 cases have been described in the literature. Herein, we reported an 80-year-old male with chronic subdural hematoma and contralateral subdural hygroma. The burr-hole craniostomy with closed-system drainage was initially performed to treat the chronic subdural hematoma. Three days after surgery, weakness of the extremities developed, and contralateral acute subdural bleeding within the previous subdural hygroma was diagnosed by CT scan of the brain. The pathophysiological mechanism of this rare complication was discussed, and the relevant literature was also reviewed. PMID:24983286

Sun, Hsiao-Lun; Chang, Chih-Ju; Hsieh, Cheng-Ta

2014-07-01

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[Cephalic index in the case of chronic subdural hematomas; a preliminary report].  

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As a low cephalic index (cephalic index = breadth x 100/length), also called "dolichocephaly" has often been observed in patients with chronic subdural hematomas, the relation between the occurrence of chronic subdural hematoma and the cephalic index was investigated. 62 patients (male: 51, female: 11) with chronic subdural hematomas who were admitted during the past 5 years, and 62 patients (male: 51, female: 11) aged 40 years and over who visited the hospital for head injury which caused no intracranial hematoma, randomly sampled, as a control group, a total of 124 patients were studied for cephalic index on plain craniogram. The average cephalic index was 79.0 for males and 81.3 for females in the chronic subdural hematoma group, compared with 82.1 for males and 83.3 for females in the control group. The former index was lower than the latter for both sexes. Dolichocephaly was observed in 8 out of 51 males (15.7%) with chronic subdural hematomas while it was observed in only 1 out of 51 males (2.0%) in the control group. Since it has been reported that dolichocephaly depends on the development of arcus superciliaris and protuberantia occipitalis externa by the interaction between androgen and GH in males as well as time of closure of the cranial suture in childhood, and as androgen accelerates offensive behavior and GH stimulates the synthesis of collagen, the occurrence of chronic subdural hematoma is potentially related with sexual or individual variation in such endocrinic environments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1542393

Sato, M; Kuwana, N; Kojima, Y; Tanaka, N

1992-02-01

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A case of acoustic neurinoma associated with chronic subdural hematoma after gamma knife radiosurgery  

International Nuclear Information System (INIS)

A 72-year-old female presented with a unique case of acoustic neurinoma with a cystic component followed by the chronic subdural hematoma manifesting as trigeminal neuralgia, facial palsy and trunchal ataxia 7 months after gamma knife radiosurgery. Magnetic resonance imaging demonstrated a loss of central contrast enhancement at the postoperative residual tumor mass and a large cyst associated with a hematoma in the subdural space. A right suboccipital craniectomy was performed. A biopsy of the mass and the membrane was performed following aspiration of the brown-reddish fluid collection. The histological diagnosis was acoustic neurinoma with a hemorrhagic necrosis. The membranous tissue mimicked an outer membrane obtained from chronic subdural hematoma. The postoperative course was satisfactory and preoperative symptom have been alleviated. In this case, the chronic subdural hematoma occurred at posterior fossa during the development of cysts caused by the radiosurgery, because the subdural space had been connected with the subarachnoid space after the first operation. The development of cysts or hematoma should be taken into consideration as possible complications following treatment with gamma knife radiosurgery for acoustic neurinomas. (author)

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Prostate dural metastasis presenting as chronic subdural hematoma. A case report and review of the literature  

Science.gov (United States)

Background: Malignant disease metastasising to the cranial dura is rare. Dural metastases manifesting as a subdural fluid collection and presenting as a chronic subdural hematoma is an uncommon entity with unknown pathophysiology. Case Description: We present a patient with known prostate cancer metastasising to the cranial dura masquerading as a chronic subdural hematoma. The patient presented with bilateral subdural collections manifesting with confusion and dysphasia. Initial drainage of the larger, symptomatic left side improved only temporarily patient's symptoms. A second drainage of the collection was performed on the same side 5 days later and dural biopsies taken during the same procedure revealed prostate metastases. The patient improved slowly and was discharged to a hospice for palliative care management. Conclusions: Prostate dural metastases should be suspected in patients with known prostate cancer presenting with a subdural collection in the absence of cranial trauma. If decision to drain the subdural collection is taken, then biopsies can be taken the same time as they can pose a diagnostic challenge. PMID:25737800

Boukas, Alexandros; Sunderland, Geraint J.; Ross, Nicholas

2015-01-01

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Iatrogenic subdural hematoma mimicking acute epidural hematoma on computed tomography  

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Full Text Available Computed tomography images of the subdural and epiduralhematoma are well defined, crescent and lentiformshapes, respectively. However, it has been reported thatboth of them might mimic each other in rare instances. Literaturereveals seven reports subdural hematoma mimickingepidural. We are reporting a new case of subduralhematoma mimicking epidural hematoma radiologically,which occurred after evacuation of chronic subdural hematomawith burr-hole in a 75 years old man. J Clin ExpInvest 2013; 4 (3: 367-369Key words: Subdural hematoma, epidural hematoma,computed tomography, brain.

Hakan Ak

2013-09-01

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Hypothalamo-pituitary dysfunction in patients with chronic subdural hematoma.  

Science.gov (United States)

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. PMID:22292726

Hána, V; Kosák, M; Masopust, V; Netuka, D; Lacinová, Z; Kršek, M; Marek, J; Pecen, L

2012-01-01

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Intrahemispheric subdural hematoma complicated with chronic neurologic diseases  

International Nuclear Information System (INIS)

Two patients had interhemispheric subdural hematoma (ISH) without clinical signs or symptoms characteristic of ISH. The first patient, a 74-year-old woman with 7 years' history of Parkinson's disease, complained of unresponsiveness and akinesia. The treatment for suspected worsening of the disease failed to improve her conditions. Computed tomography (CT) showed hyperdensity along the falx from the frontal falx over the tentorium. Subsequent CT on the 23rd hospital day showed disappearance of hyperdensity, confirming ISH. The second patient, a 76-year-old woman with multiple cerebral infarction, was referred for loss of consciousness and vomiting. Neurological examination failed to reveal additional or augmented neurological deficits. Computed tomography showed a right parasagittal thin crescent hyperdensity with a flat medial border and a convex lateral border, extending from the anterior falx to the mid-falx. The hyperdensity disappeared on the 47th hospital day. These findings suggest the usefulness of CT as the only procedure when ISH features are not seen. (Namekawa, K.)

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Hematoma subdural espinal no traumático / Nontraumatic spinal subdural hematoma  

Scientific Electronic Library Online (English)

Full Text Available Un paciente varón de 88 años, en diálisis por insuficiencia renal crónica, presentó cervicalgia intensa y, progresivamente, déficit sensitivo motor completo dependiente de ventilación mecánica. La tomografía cervicodorsal y la resonancia magnética (RM) inicial sugirieron varios diagnósticos, entre e [...] llos hematoma subdural espinal. El tiempo de protrombina y el INR estaban ligeramente fuera del rango normal y las plaquetas eran normales. La RM contrastada hecha al cuarto día indicaba la probable presencia de un hematoma espinal. Se realizó una punción lumbar, la que confirmó in hematoma subdural espinal en fase crónica. Se evacuó 60 mL, sin obtener mejora clínica neurológica. No fue posible realizar una RM de control, debido a la condición clínica del paciente. El paciente falleció debido a una sepsis de foco respiratorio. Abstract in english A 88yearold male receiving hemodialysis for chronic renal insufficiency, developed cervical pain and progressively motor/sensitive deficit with mechanic ventilation support. Computed tomography and Magnetic resonance imaging (MRI) admission showed a variety of diagnostics, inclunding spinal subdural [...] hematoma. Prothrombin time and international normalized ratio (INR) were slightly out of range, with normal platelets amount. MRI after four days found a spinal subdural hematoma, confirmed with lumbar puncture. Sixty cc was evacuated without neurologic amelioration. A new MRI was impossible to perform. He died due a respiratory sepsis.

Carlos, Casallo-Quiliano; Dennis, Dávila-García; Catherine, Ruiz-Perea; Ronald, Pineda-García.

2014-10-01

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Clinical usefulness of determination of NSE contents in drainage fluid of patients with chronic subdural hematoma  

International Nuclear Information System (INIS)

Objective: To investigate the relationship between the neuron-specific enolase (NSE) contents of serum and drainage fluid in patients with chronic subdural hematoma (CSDH). Methods: Serum and drainage fluid NSE contents were determined with RIA right after and 24, 48, 72, 96, 120 hours after trephining in 28 patients with CSDH as well as 28 controls (once and serum only). Results: The serum contents of NSE in the patients were significantly higher than those in the controls (P<0.01). The drainage fluid contents of NSE were correlated with the patients concurrent own serum NSE contents (r=0.917) and were higher than the respective serum NSE value (P<0.01). All the NSE contents dropped continuously throughout the observation period. Conclusion: Changes of drainage fluid NSE contents might reflect progress of the degree of nervous tissue injury in patients with chronic subdural hematoma. (authors)

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Chronic subdural hematoma with sedimentation level on CT: correlation with clinical and operative findings  

International Nuclear Information System (INIS)

The purpose of this study is to correlate CT findings of the patients with chronic subdural hematoma(SDH) showing a sedimentation level with their clinical and operative findings. We selected 9 patients who showed a sedimentation level within the hematoma after reviewing the CT findings of 55 patients with SDH. We also analyzed their age, initial symptoms, cause of head injury, latent period, the level of consciousness on admission, CT findings, and operative findings. All of the 9 patients were aged persons(over 52 years). They had a history of acute exacerbation of neurologic symptoms. Five of them had an apparent history of head trauma more than one month before the exacerbation. The CT scans showed unilateral, crescent-shaped subdural fluid collection with a sedimentation level except a case of bilateral SDH and 2 cases of planoconvex-shaped SDH. The interface of the sedimentation level was sharp in 3 cases and indistinct in 6 cases. None had bleeding tendency and the hemoglobin level was slightly decreased in 2 patients. All patients revealed membrane of the hematoma during operation. The upper portion of the sedimentation was liquefied blood and the lower portion was fresh blood clots. We could observe fresh RBC's in the hematoma microscopically. A sedimentation level in chronic SDH was operatively proved to represent rebleeding, and was clinically manifested as an acute exacerbation of symptoms

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Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM  

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Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paciente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar.

Leodante B. Costa Jr

2004-03-01

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Chronic subdural hematomas as evaluated by measns of SPECT, CT and EEG topography  

International Nuclear Information System (INIS)

Nineteen patients with chronic subdural hematomas were reviewed, and, in an attempt to delineate the pathophysiology of this condition, evaluations were made by means of single-photon-emission tomography (SPECT), computed tomography (CT), and electroencephalographic (EEG) topography. Choronic subdural hematomas were classified into three types on the basis of their SPECT appearances: Type I: normal cerebral blood flow (CBF) in the basal ganglionic region, with or without a decreased mean cerebral hemispheric CBF on the affected side; Type II: decreased basal ganglionic as well as mean cerebral hemispheric CBF on the affected side; Type III: Diffuse, marked reduction of CBF on both sides. In 11 patients with headaches, the SPECT images were often classified as Type I, in which there was a normal regional CBF in the basal ganglia. In the majority, CT scans revealed either hypo- or iso-density in the lesions, with a minimal midline shift. No evidence of focal slow waves was seen on the EEG topograms. On the other hand, 6 patients with hemiparesis demonstrated, on their SPECT images, a relative reduction of both hemispheric and basal ganglionic CBF, as designated as Type II. CT showed high- or mixed-density, and focal slow waves were found on the EEG topograms. Subsequent measurements of the CBF after the evacuation of the hematomas in 13 patients disclosed a 10-20% increase in both hemispheric and basal ganglionic CBF, particularly in patients younger than 65. The presenly in patients younger than 65. The present clinical studies suggest a critical role of CBF, especially basal ganglionic CBF, in the pathophysiology of chronic subdural hematomas. (author)

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Dexamethasone treatment in chronic subdural haematoma / Tratamiento con dexametasona del hematoma subdural crónico  

Scientific Electronic Library Online (English)

Full Text Available RESUMEN Introducción. El hematoma subdural crónico (HSC) es una entidad clínica bien conocida por los neurocirujanos, cuyo tratamiento habitual es la evacuación del mismo a través de alguna modalidad de trepanación. A pesar de los excelentes resultados así obtenidos, pueden ocurrir diversas complica [...] ciones, algunas de las cuales son potencialmente graves o mortales. Además, la tasa de recidivas puede alcanzar el 25% de los casos. Presentamos una aproximación novedosa al manejo del HSC, basada en la utilización de dexametasona como tratamiento de elección en la gran mayoría de los pacientes. Pacientes y métodos. Se analizaron los historiales médicos de 122 pacientes consecutivos diagnosticados de HSC. Al ingreso todos los pacientes sintomáticos fueron clasificados mediante la Escala de Puntuación de Markwalder (EPM). Aquellos con EPM de 1-2 fueron asignados al Protocolo de Dexametasona (4mg cada 8h, re-evaluación a las 72h y disminución progresiva de dosis) y aquellos con EPM de 3-4 se asignaron, en general, al Protocolo Quirúrgico (único mini-trépano tipo twist-drill frontal, sin irrigación y drenaje a sistema cerrado). El seguimiento clínico se realizó mediante TAC y valoración neurológica en la consulta externa. Resultados. En el período entre Marzo 2001 y Mayo 2006, se trataron 122 pacientes con HSC (69% varones) con una mediana de edad de 78 años (rango 25-97). El 73% de los pacientes presentaban algún déficit neurológico (EPM 2-3-4). No se trataron pacientes asintomáticos (EPM 0). La asignación inicial de tratamientos fue: 101 dexametasona, 15 drenaje subdural, 4 craneotomía y 2 no recibieron tratamiento. Precisaron drenaje 22 pacientes inicialmente asignados a dexametasona (21.8%). Se obtuvo resultado favorable (EPM 0-12) en el 96% y 93.9% de los tratados con dexametasona y drenaje, respectivamente. La mediana de estancia fue de 6 días para el grupo de dexametasona y para la serie al completo (rango 1-41), y de 8 días para el grupo intervenido (rango 5-48). La mortalidad global fue del 0.8% y la proporción de reingresos debido al HSD del 14.7% (todos mejoraron o estabilizaron su EPM). Ocurrieron complicaciones médicas en 34 pacientes (27.8%), fundamentalmente descompensaciones hiperglucémicas leves. El seguimiento mediano extrahospitalario de la serie fue de 25 semanas (rango 8-90), con dos únicas pérdidas. Discusión. La utilización de dexametasona en el HSC se basa en sus propiedades antiangiogénicas sobre la membrana del coágulo subdural, según se desprende de estudios experimentales y de las muy escasas observaciones clínicas publicadas. El tratamiento quirúrgico del HSC es conocido que obtiene excelentes resultados, aunque no existen ensayos bien diseñados que comparen ambas modalidades terapéuticas. La experiencia que aporta esta serie nos permite realizar una serie de consideraciones clínicas: el tratamiento del HSC con dexametasona es factible y se compara positivamente con el tratamiento quirúrgico (evitó dos tercios de las intervenciones en nuestra serie); creemos que la historia natural del HSC permite un período de prueba con dexametasona (48-72h) sin someter a riesgo de deterioro irreversible al paciente; se elimina toda la morbilidad asociada a las intervenciones y las recidivas; no provoca complicaciones significativas; reduce la estancia media; no impide ni perjudica un ulterior tratamiento quirúrgico; es una terapia bien tolerada y entendida por el paciente y sus acompañantes y, posiblemente, abarata costes. Los autores proponen un protocolo de manejo que no pretende sustituir al tratamiento quirúrgico sino ofrecer una alternativa efectiva y segura. Conclusión. Los datos obtenidos de esta larga serie retrospectiva sugieren que la utilización de dexametasona en el HSC es una opción factible y segura. En nuestra experiencia, curó o mejoró a dos tercios de todos los pacientes, hecho que debe ser corroborado por otros autores. La verdadera efectividad de esta terapia podría ser objeto, idealmente, de un ensayo aleat

P.D., Delgado-López; V., Martín-Velasco; J.M., Castilla-Díez; A., Rodríguez-Salazar; A.M., Galacho-Harriero; O., Fernández-Arconada.

2009-08-01

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Clinical study of cerebral blood flow in bilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT  

International Nuclear Information System (INIS)

Cerebral blood flow (CBF) in 34 patients with bilateral chronic subdural hematoma was measured by 99mTc-HMPAO SPECT before operation. The regional CBF was measured in 26 regions of the 10 cortical regions, putamen, thalamus and cerebellar hemisphere on both sides. According to the thickness of subdural hematoma, the thicker hematoma side was measured and examined as the thick hematoma side, and the other side as the thin hematoma side. Thirty four cases with bilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms :13 cases with headache (headache group), 10 cases with hemiparesis (hemiparesis group), 5 cases with tetraparesis (tetraparesis group) and 6 cases with consciousness disturbance or dementia (consciousness disturbance group), and into two groups according to the degree of midline brain shift on MRI: 14 cases of non-shifted group and 20 cases of shifted group. The average CBF of 34 patients in each region indicated a regional CBF reduction in the frontal, parietal and occipital cortices on the thin hematoma side, and in the putamen on the thick hematoma side. In the headache group, the regional CBF reduction on the thin hematoma side was found in the frontal, parietal and occipital cortices compared with the corresponding regions on the thick hematoma side, and in thalamus on the thick hematoma side. In the hemiparesis and tetraparesis groups, there was no statistically significant CBF reduction betweenstically significant CBF reduction between the thick and thin hematoma sides. In the consciousness disturbance group, the CBF reduction in whole brain was remarkably significant. By the degree of the midline brain shift, the CBF reductions between the thick and thin hematoma sides were observed. Namely, in the shifted group, the CBF reductions were noted in the frontal, parietal and occipital cortices in the thin hematoma side, and in the putamen in the thick hematoma side. We concluded that the CBF reduction of bilateral chronic subdural hematoma was bilaterally found in the hemiparesis and tetraparesis groups, and which was finally observed in whole brain in the consciousness disturbance group. (author)

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Recurrence factors for chronic subdural hematoma after burr-hole surgery  

International Nuclear Information System (INIS)

Although chronic subdural hematoma (CSDH) is well known as a curable condition, it also has a significant recurrence rate. To identify risk factors for recurrence, we compared the clinical features in two groups of patients with or without recurrence. The present study included 172 adult patients who had underwent one burr-hole and closed-system drainage between April 2007 and January 2010. Of these 23 cases (13.4%) experienced recurrence after surgery. The factors analyzed were patient background including, gender, age, history of drinking, diabetes, and the use of antiplatelet or anticoagulant medications, and a history of head injury, clinical symptoms, including initial neurologic symptoms, and computed tomography findings such as hematoma thickness, midline-shift, and density of the hematoma factors related to surgery such as duration from trauma to surgery and operation method and the recurrence rate. The results of this study showed that a short duration from trauma to surgery and the absence of traumatic history were recurrence factors for CSDH after burr-hole surgery. These results suggest that any cases with these risk factors should be closely observed after burr hole surgery. (author)

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Intracranial aneurysms causing spontaneous acute subdural hematoma  

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Full Text Available Acute subdural hematoma is an uncommon presentation of the rupture of an intracranial aneurysm. We report two cases of intracranial aneurysms causing spontaneous acute subdural hematoma.

Shenoy S

2003-07-01

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Spinal subdural hematoma associated with traumatic intracranial interhemispheric subdural hematoma.  

Science.gov (United States)

A 78-year-old female fell and hit the back of her head on the floor. Head computed tomography (CT) showed right acute interhemispheric subdural hematoma (ISDH). Her left hemiparesis worsened, so partial removal of ISDH was performed. The hemiparesis was improved, but leg monoparesis persisted. Lumbar magnetic resonance imaging showed spinal subdural hematoma (SSDH) at the S1-2 level. Nerve conduction velocity measurements at the knee joint to lower limb showed disappearance of the left peroneal nerve conduction wave, indicating that one of the causes of drop foot was common peroneal nerve palsy. With conservative therapy, her drop foot was gradually improved, then she recovered to walk with a stick and moved to a rehabilitation hospital. Lumbar MR imaging should be performed to rule out SSDH in a patient with posterior fossa subdural hematoma on initial head CT who develops leg palsy. PMID:23006875

Wajima, Daisuke; Yokota, Hiroshi; Ida, Yuki; Nakase, Hiroyuki

2012-01-01

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A case of chronic subdural hematoma associated with an unruptured cerebral aneurysm detected by cerebral computed angiotomography  

International Nuclear Information System (INIS)

One case of chronic subdural hematoma associated with an unruptured cerebral aneurysm detected by cerebral computed angiotomography is reported. A 44-year-old female slipped and hit her head without loss of consciousness, one month ago. Recently she complained of headaches and visited the department of Neurosurgery, Washokai Sadamoto Hospital on May 21, 1985. There were no physical and neurological signs on examination. Plain CT scans showed a crescent-shaped high density area in the left frontal region with a slight mass sign. She was diagnosed as having a possible chronic subdural hematoma and further examination was recommended. Biplane ultrafast overlapping cerebral computed angiotomograms clearly demonstrated a so-called avascular area delineated by enhanced superficial cerebral vessels with contrast medium. Furthermore, a marked high density mass measuring 8 mm x 10 mm x 6 mm in diameters was simultaneously demonstrated around the right anterior clinoid process on the same image, suggesting a cerebral aneurysm. Right carotid angiograms showed a right internal carotid-posterior communicating junction aneurysm. The irrigation of the left chronic subdural hematoma was carried out on May 24 and the neck clipping of the right IC-PC junction aneurysm was done two weeks later. During the operation, there were no findings suggesting a previous subarachnoid hemorrhage from the aneurysm, but a bleb was found on the aneurysm. The post-operative course was uneventful. (J.P.N.)

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Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma Chronic subdural hematoma: study of 161 patients and the relationship with coagulation abnormalities  

OpenAIRE

O objetivo deste estudo é analisar a evolução de pacientes com hematoma subdural crônico em relação aos achados do coagulograma. Foram analisados 161 pacientes operados no Hospital das Clínicas-UNICAMP entre abril de 1994 e 2000. Foi detectado um predomínio do sexo masculino (86,3%), da cor branca (85,1%) e da faixa etária na quinta década (mediana 57 anos). O estudo mostrou mortalidade maior no período pós-operatório entre os pacientes com valores de RNI (international normalize...

Clarissa Lin Yasuda; Márcia Elisabete Morita; Fernanda Yoshi Nishimori; Agnes Meri Yasuda; Hélvio Leite Alves

2003-01-01

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Differential diagnosis of frontal lobe atrophy from chronic subdural hematoma or subdural hygroma on CT in aged patients. Usefulness of CT cisternogram  

International Nuclear Information System (INIS)

Metrizamide CT cisternograms (CTC) were performed in order to examine the CSF passage to subarachnoid space, cerebral sulci and Sylvian fissure. The old aged 20 patients (from 63 to 88 years old) with the layer of low density area around bilateral frontal lobe (bi-frontal LDA) in plain CT finding were selected from 2000 aged patients hospitalized in Hanwa-Senboku Hospital. In these 20 patients, it was difficult to differentiate frontal lobe atrophy from the chronic subdural hematoma and subdural hygroma. Conservative therapy was applied in 19 patients for their old age or their complicated diseases. Only 1 patient was operated for subdural hygroma. The 20 patients were investigated in EEGs, severity of dementia, disturbance of consciousness, activity of daily life, their clinical course and prognosis. Only 2 of the 11 patients with type 1 CTC findings (cerebral sulci, Sylvian fissure and bi-frontal LDA were simultaneously enhanced by metrizamide) showed disturbance of consciousness and/or delirium for their serious somatic disorders. All of 6 patients with type 3 CTC findings (only bi-frontal LDA was not enhanced by metrizamide) showed disturbance of consciousness. Three patients with type 2 CTC findings (atypical findings) were reported independently. Subdural disorder elevating intracranial pressure were clarified in the cases with type 3 CTC findings. (author)

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Traumatic subdural hematoma in the lumbar spine.  

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Traumatic spinal subdural hematoma is rare and its mechanism remains unclear. This intervention describes a patient with mental retardation who was suffering from back pain and progressive weakness of the lower limbs following a traffic accident. Magnetic resonance imaging of the spine revealed a lumbar subdural lesion. Hematoma was identified in the spinal subdural space during an operation. The muscle power of both lower limbs recovered to normal after surgery. The isolated traumatic spinal subdural hematoma was not associated with intracranial subdural hemorrhage. A spinal subdural hematoma should be considered in the differential diagnosis of spinal cord compression, especially for patients who have sustained spinal trauma. Emergency surgical decompression is usually the optimal treatment for a spinal subdural hematoma with acute deterioration and severe neurological deficits. PMID:21943822

Song, Jenn-Yeu; Chen, Yu-Hao; Hung, Kuang-Chen; Chang, Ti-Sheng

2011-10-01

55

Contralateral acute subdural hematoma following traumatic acute subdural hematoma evacuation.  

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Contralateral acute subdural hematoma (ASDH) occurring after removal of traumatic ASDH is a rare, but nearly devastating postoperative complication. We treated a 26-year-old male who developed a contralateral ASDH shortly after craniectomy for evacuation of a traumatic ASDH. Burr-hole craniotomy was performed before decompressive craniectomy, and the bleeding source was a cortex artery within the frontal lobe contusion. Despite supportive therapy with barbiturate and mild hypothermia he expired 3 days later of brain death. Literature review suggests that the old are more susceptible to contralateral ASDH following evacuation of traumatic ASDH. Contralateral ASDH following evacuation of traumatic ASDH is a rare but potentially lethal complication, so neurosurgeons should try to detect such contralateral hematoma formation and prevent clinical deterioration. PMID:23615411

Shen, Jian; Fan, Zuoxu; Ji, Tao; Pan, Jianwei; Zhou, Yongqing; Zhan, Renya

2013-01-01

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Diffuse Presence of Myeloblasts in Chronic Subdural Hematoma of a Young Adult Patient without Systemic Hematologic Disorder  

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Objective?Myeloblasts are rarely found in the composition of a chronic subdural hematoma (CSH), and reported cases with myeloblasts in CSH have all been associated with systemic hematologic disorders. We present a young man with CSH manifesting the diffuse presence of myeloblasts, although no systemic hematologic disorders were identified. Participant?A 27-year-old man, complaining of a headache lasting for a few months, was diagnosed with right CSH, and the aspirated hematoma was sent for cytological evaluation because no apparent etiologic episode was found. The diffuse presence of precursor cells, such as myeloblasts and erythroblasts, mimicking the aspirated bone marrow, was confirmed. This finding was suggestive of a systemic hematologic disorder, although the systemic evaluations were negative. Results?The patient's hematoma reaccumulated twice, and finally hematoma and enhanced dura were removed by craniotomy under general anesthesia. Further histologic evaluation did not show any precursor cells, and he has remained asymptomatic for?>?2 years without any evidence of the hematologic disorder. Conclusion?We believe this is the first case with CSH that contained myeloblasts as well as erythroblasts in an otherwise healthy patient. A possible etiology was considered for the origin of precursor cells in his CSH. PMID:25083371

Yokoyama, Shota; Fukuhara, Toru; Namba, Yoichiro; Asakura, Shoji

2014-01-01

57

Bilateral chronic subdural hematomas resulting in unilateral oculomotor nerve paresis and brain stem symptoms after operation--case report.  

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An 85-year-old male presented with bilateral chronic subdural hematomas (CSDHs) resulting in unilateral oculomotor nerve paresis and brainstem symptoms immediately after removal of both hematomas in a single operation. Initial computed tomography on admission demonstrated marked thick bilateral hematomas buckling the brain parenchyma with a minimal midline shift. Almost simultaneous removal of the hematomas was performed with the left side was decompressed first with a time difference of at most 2 minutes. However, the patient developed right oculomotor nerve paresis, left hemiparesis, and consciousness disturbance after the operation. The relatively marked increase in pressure on the right side may have caused transient unilateral brain stem compression and herniation of unilateral medial temporal lobe during the short time between the right and left procedures. Another factor was the vulnerability of the oculomotor nerve resulting from posterior replacement of the brain stem and stretching of the oculomotor nerves as seen on sagittal magnetic resonance (MR) images. Axial MR images obtained at the same time demonstrated medial deflection of the distal oculomotor nerve after crossing the posterior cerebral artery, which indicates previous transient compression of the nerve and the brain stem. Gradual and symmetrical decompression without time lag is recommended for the treatment of huge bilateral CSDHs. PMID:10481440

Okuchi, K; Fujioka, M; Maeda, Y; Kagoshima, T; Sakaki, T

1999-05-01

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Estimation of Chronic Subdural Hematoma Size Using CT Imaging; a Comparison of In-Plane Thickness to 3D Volumetry  

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Full Text Available Backgrounds: Pre- and postoperative chronic subdural hematoma (CSDH sizes have been used in clinical trials to predict the risk of postoperative recurrence. Commonly, dimensions of the pre- and postoperative lesions have been assessed by computerized tomography (CT scans using maximum thickness as a linear measurement. Our goal was to characterize this common method for quantification of pre- and postoperative lesion sizes and to assess its estimation validity compared to estimation by hematoma volumetry. Methods: We prospectively investigated pre- and 1st postoperative day CT scans of 107 adult surgical patients with uni- or bilateral CSDH. Pre- and postoperative thickness of CSDH was determined and then compared to pre- and postoperative lesion volume measured with 3D hematoma volumetry. Results: Pearson correlation coefficients between mean pre- and postoperative lesion thickness and mean pre- and postoperative lesion volume in the unilateral subgroup were 0.491 and 0.498, respectively; in the bilateral subgroup 0.505 and 0.579, respectively; and in the whole series 0.653 and 0.472, respectively. Conclusions: Pre- and postoperative thickness of CSDH does not offer reasonable approximations of the pre- and postoperative lesion size when compared with results from 3D volumetry in the unilateral subgroup, bilateral subgroup or overall.

Milo Staniši?

2013-12-01

59

MRI findings of traumatic spinal subdural hematoma  

International Nuclear Information System (INIS)

To describe the MR imaging findings of traumatic spinal subdural hematoma. We retrospectively reviewed the MR images of six patients, with symptoms of acute spinal cord or cauda equena compression after trauma, together with spinal subdural hematoma. We analyzed the extent, location, configuration and signal intensity of the lesions. In five of sex cases, hematomas were distributed extensively throughout the thoracolumbosacral or lumbosacral spinal levels. In five cases they were located in the dorsal portion of the thecal sac, and in one case, in the ventral portion. On axial images, hematomas showed a concave or convex contour, depending on the amount of loculated hematoma. A lobulated appearance was due to limitation of free extension of the hematoma within the subdural space at the lateral sites (nerve root exist zone) at whole spine levels, and at the posteromedian site under lumbar 4-5 levels. In cases of spinal subdural hematoma, the lobulated appearance of hematoma loculation in the subdural space that bounds the lateral sites at al spinal levels and at the posteromedian site under L4-5 levels is a characteristic finding. (author)

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Recovery of cerebral blood flow in unilateral chronic subdural hematoma. The correlation with cerebral re-expansion in elders  

International Nuclear Information System (INIS)

CT and SPECT were used to investigate the relationship between cerebral re-expansion and changes in cerebral blood flow underneath hematoma in elderly patients after surgery for chronic unilateral subdural hematoma. I studied 22 patients with mild hematoma, aged 43 to 82 years (mean 67 years). The patients were placed in either Group A (under 70 years) or Group B (70 years or over) to observe postoperative changes. CT and SPECT examinations were conducted before surgery and 1, 7 and 30 days after surgery, 4 times in total. Cerebral re-expansion was represented by the re-expansion rate (PER) comparing the pre- and postoperative thickness of the maximal hematoma in CT images. The rate of cerebral re-expansion was slowed in Group B (p<0.01). Cerebral re-expansion was characterized by biphasic, rapid or gradual re-expansion on postoperative day 1 with a significant difference between groups (p<0.01). Before surgery, cerebral blood flow on the affected side correlated with age (p<0.01), thougn blood flow was diminished in both groups. After surgery, cerebral blood flow on the affected side exceeded that on the unaffected side in Group A and transiently increased on postoperative day 1. Cerebral blood flow improved after surgery in both groups, with a significant difference in those changes over time (p<0.01). In both groups, cerebral re-expansion on postoperative days 7 and 30 correlated with cerebral blood flow on the affected side (p<0.05). The present results suggest the (p<0.05). The present results suggest that improvement in cerebral blood flow on the affected side is delayed in elderly patients, due to slower postoperative cerebral re-expansion. (author)

61

Simultaneous Intracranial and Spinal Subdural Hematoma: Two Case Reports  

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Spinal subdural hematoma is a rare disease. Simultaneous intracranial and spinal subdural hematoma is extremely rare and only 14 such cases have been reported. We report here on two cases of simultaneous intracranial and spinal subdural hematoma that occurred following a fall-down head injury and intracranial surgery, and we discuss the pathogenesis of the disease.

Yoon, Chung Dae; Song, Chang Joon; Lee, Jeong Eun; Choi, Seung Won [Chungnam National University, Daejeon (Korea, Republic of)

2009-02-15

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Eotaxin-3 activates the Smad pathway through the transforming growth factor beta 1 in chronic subdural hematoma outer membranes.  

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Chronic subdural hematoma (CSDH) is considered to be an inflammatory disease. Eosinophils are frequently expressed in the outer membrane of CSDH and are major sources of transforming growth factor beta (TGF-?). The mothers against decapentaplegic (Smad)-signaling pathway, which is activated by TGF-?, has been shown to be involved with fibrosis. In the present study, we compared the concentrations of eotaxin-3, eosinophil-specific chemoattractant, and TGF-? between CSDH fluid and cerebrospinal fluid (CSF) from control patients. We also explored the expression of the Smad-signaling pathway in the outer membrane of CSDH. Eight patients whose outer membrane and 12 whose CSDH fluid were successfully obtained during trepanation surgery were included in the study. Concentrations of eotaxin-3 and TGF-? were measured by enzyme immunoassay kits. Expression levels of Smad2, phosphorylated Smad3, Smad3, Smad4, and actin were examined by Western blot analysis. In addition, expression of Smad3 was also examined by immunohistochemistry. Concentrations of eotaxin-3 and TGF-? in CSDH fluid were significantly higher than those in CSF. Smad2, Smad3, phosphorylated Smad3, and Smad4 were detected in all cases. Smad3 was shown to be present in fibroblasts. These findings indicate that eotaxin-3 is expressed in CSDH fluid, inducing eosinophils into the outer membrane and resulting in elevation of TGF-? with the Smad pathway activated by TGF-?. These data suggest a potential mechanism for CSDH formation and growth. PMID:24684589

Osuka, Koji; Watanabe, Yasuo; Usuda, Nobuteru; Aoyama, Masahiro; Takeuchi, Mikinobu; Takayasu, Masakazu

2014-08-15

63

Comparison of Burr Hole Irrigation and Closed System Drainage Methods After Burr Hole Irrigation in The Treatment of Chronic Subdural Hematoma  

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Full Text Available Objective: Comparison of evacuation of hematoma through burr hole irrigation (BHI and closed system drainage (CSD after burr hole irrigation in the treatment of chronic subdural hematoma (CSDH in terms of relapse.Materials and Methods: 32 patients who were operated with CSDH diagnosis between 2001 and 2008 were retrospectively evaluated with respect to clinical features, etiologic factors, surgical technique and recurrence. Of the 5 recurrent cases in BHI group, 2 (20% received tap and 3 received excision of hematoma via craniotomy. No pathology requiring additional surgery was detected in the follow-up of the patients who underwent BHI-CSD.Conclusion: Closed system drainage through burr hole irrigation in CSDH cases is a simple and reliable method which reduces the risk for recurrence and reoperation and enables evacuation of anticoagulants such as plasminogen and thrombomodulin, products of impaired coagulation- anticoagulation balance.

Murat GÜNAL

2012-06-01

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CT findings in a case of neonatal acute subdural hematoma  

International Nuclear Information System (INIS)

The CT findings in a case of neonatal accute subdural hematoma are presented. CT demonstrated a crescentic high density area in the subdural space over the left cerebral hemisphere and an oval high density area in the left occipital region. The latter was suspected of being an intracerebral hematoma. Emergency craniotomy revealed that the high density area was due to a subdural hematoma between the occipital lobe and the tentorium cerebelli. (orig.)

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Calcified subdural hematoma associated with hypertensive intracerebral hemorrhage  

International Nuclear Information System (INIS)

A case of calcified subdural hematoma associated with hypertensive intracerebral hemorrhage is reported. A left frontal subdural hematoma with left putaminal hemorrhage was incidentally found when a CT scan was performed to evaluate right hemiparesis and aphasia in a 55-year-old man. The putaminal hemorrhage was not very extensive, but his clinical symptoms were rather serious. Not only the putaminal hemorrhage, but also the presence of the calcified subdural hematoma was considered to have caused his clinical deterioration. The subtotal removal of the calcified subdural hematoma brought about a good result. (author)

66

Endoscopic Surgery for Traumatic Acute Subdural Hematoma  

OpenAIRE

Traumatic acute subdural hematoma (ASDH) is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering he...

Kon, Hiroyuki; Saito, Atsushi; Uchida, Hiroki; Inoue, Mizuho; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

67

Acute Spontaneous Subdural Hematoma of Arterial Origin  

OpenAIRE

Acute spontaneous subdural hematoma (SDH) of arterial origin is very rare. We report a case of acute spontaneous SDH that showed contrast media extravasation from cortical artery on angiograms. A 58-year-old male patient developed sudden onset headache and right hemiparesis. Brain CT scan demonstrated acute SDH at left convexity. The patient was drowsy mentality on admission. He had no history of head trauma. Cerebral angiography was performed and revealed a localized extravasation of the con...

Sung, Soon Ki; Kim, Sung Hoon; Son, Dong Wuk; Lee, Sang Weon

2012-01-01

68

Involvement of hypoxia-inducible factor-1? and vascular endothelial growth factor in the mechanism of development of chronic subdural hematoma  

International Nuclear Information System (INIS)

Vascular endothelial growth factor (VEGF), a potent inducer of angiogenesis and vascular permeability in diverse physiological and pathological conditions, may be involved in the pathophysiology of chronic subdural hematoma (CSDH). The present study investigated the source and mechanisms for the induction of VEGF in CSDH by measuring the concentration of VEGF in the hematoma of 102 patients (122 hematomas) using the enzyme-linked immunosorbent assay technique. The relationship between the VEGF concentration in hematoma and the intrahematoma membranous structure confirmed by preoperative T2*-weighted magnetic resonance image was examined in 46 of these patients. VEGF and hypoxia-inducible factor-1? (HIF-1?) expression was immunohistochemically studied and microvessel density (MVD) in the outer membrane was identified using anti-CD31 antibody in 30 patients. VEGF and HIF-1? were positive in the outer membranes of all 30 patients. VEGF expression was significantly correlated to HIF-1? expression (rs= 0.651, p=0.0084) and VEGF concentration in the hematoma (rs=0.654, p=0.0013). VEGF concentration in layered hematomas, which have intrahematoma membranous structure, was significantly higher than in non-layered hematomas (p<0.01). Although MVDs of the outer membranes were comparable to those described in tumors, there was no significant relationship with VEGF expression. The present study suggests that VEGF in CSDH, which may be induced it VEGF in CSDH, which may be induced in the neomembrane by HIF-1 release, may give rise to the excessive development of fragile microvessels and hyperpermeability, resulting in the enlargement of CSDH. (author)

69

Follow up study and interested cases in subdural hematoma  

International Nuclear Information System (INIS)

1. Out of 67 patients ranging from 16 to 82 years old, 20 were followed up by CT scan after operation. 2. Five patients presented hematoma on the both sides after operation, though they had suffered from the lesion of one side before operation. In four patients, hematoma was observed on the both sides before and after operation. Neither preoperative involved side changed nor hematoma appeared on the opposite side after operation in 11 patients. Follow-up examinations lasted up almost three months. 3. The maximum width of the subdural space was divided by the maximum intracranial width. These two factors were measured on horizontal CT scan. The calculated value was expressed in percentage and then, the result was regarded as Subdural Space (SDS) Index. Dividing a difference between the largest SDS Index (before operation) and the smallest by the number of days between the two points gave us a reduction rate of SDS Index. As a result, a reduction rate of 0.4 or less was obtained in all the patients less than 65 years old. There were three patients within the range from 0.7 to 1.0 of the rate. 76-year-old patients showed 2.6 and 5.7. Except the 76-old patients, mean duration of 35.5 days was calculated in Group I and SDS Index was 0, while Group II showed mean duration of 52.4 days, resulting in SDS Index of 0. 4. Specific progresses are shown below: 1) Hemorrhage of the caudate nucleus after operation 2) Subdural effusion of the both sides 3) Appearance of abscess 4) Su both sides 3) Appearance of abscess 4) Subtentrial hemorrhage after operation 5) Postoperative epidural hematoma 6) Traumatic intracerebral hemorrhage, resulting in chronic subdural hematoma six months afterward (author)

70

Intracranial Subdural Hematoma after Spinal Anesthesia for Cesarean Section  

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Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence in the obstetric population. Nevertheless, it is a potentially life-threatening complication. In the majority of the cases, the first clinical symptom associated with intracranial subdural bleeding is severe headache, but the clinical course may have different presentations. In this report, we describe the case of a 38-year-old woman with an acute intracranial subdural hematoma shortly after spinal anesthes...

Vittorio Schweiger; Giovanni Zanconato; Gisella Lonati; Silvia Baggio; Leonardo Gottin; Enrico Polati

2013-01-01

71

Effect of platelet-activating factor receptor antagonist, etizolam, on resolution of chronic subdural hematoma. A prospective study to investigate use as conservative therapy  

International Nuclear Information System (INIS)

Inflammatory reaction is very important for formation of the neomembrane of chronic subdural hematoma (CSDH). The present study evaluated medical treatment with the platelet-activating factor receptor antagonist, etizolam, for the resolution of CSDH, and the factors indicating surgery or conservative therapy. Alternate patients were assigned to the etizolam group or control group without medical treatment. Patients in the etizolam group received 3.0 mg etizolam per day for 14 days. A total of 53 patients were followed up for at least 6 months. Univariate analysis of differences in demographic characteristics, clinical findings, and initial computed tomography (CT) findings, and multiple logistic regression analysis of the relationship between etizolam treatment and requirement for surgery using age, sex, low density of hematoma on CT, and paresis as confounders were performed. Etizolam treatment (adjusted odds ratio [OR] 0.156, 95% confidence interval [CI] 0.024-0.999, p=0.049) was negatively correlated with requirement for surgery. Low density of hematoma (adjusted OR 0.125, 95% CI 0.019-0.846, p=0.033) was found to be an independent negative predictor, and paresis as an initial symptom (adjusted OR 6.35, 95% CI 1.04-38.7, p=0.045) was an independent positive predictor of requirement for surgery. Etizolam administration can promote the resolution of CSDH, especially at the stage of hygroma appearing as low density on CT. Surgery is recommended if the patient presentsery is recommended if the patient presents with paresis. (author)

72

MRI findings in spinal subdural and epidural hematomas  

International Nuclear Information System (INIS)

Background: Spinal hematomas are rare entities that can be the cause of an acute spinal cord compression syndrome. Therefore, an early diagnosis is of great importance. Patients and Methods: From 2001 to 2005 seven patients with intense back pain and/or acute progressive neurological deficit were studied via 1.5 T MRI (in axial and sagittal T1- and T2-weighted sequences). Follow-up MRI was obtained in six patients. Results: Four patients showed the MRI features of a hyperacute spinal hematoma (two spinal subdural hematoma [SSH] and two spinal epidural hematoma [SEH]), isointense to the spinal cord on T1- and hyperintense on T2-weighted sequences. One patient had an early subacute SEH manifest as heterogeneous signal intensity with areas of high signal intensity on T1- and T2-weighted images. Another patient had a late subacute SSH with high signal intensity on T1- and T2-weighted sequences. The final patient had a SEH in the late chronic phase being hypointense on T1- and T2-weighted sequences. Discussion: MRI is valuable in diagnosing the presence, location and extent of spinal hematomas. Hyperacute spinal hematoma and the differentiation between SSH and SEH are particular diagnostic challenges. In addition, MRI is an important tool in the follow-up in patients with conservative treatment

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Endoscopic surgery for traumatic acute subdural hematoma.  

Science.gov (United States)

Traumatic acute subdural hematoma (ASDH) is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering head trauma and right hemiplegia. Her Glasgow Coma Scale score was 8 (E2V2M4). Computed tomography (CT) demonstrated a thick, left-frontotemporal ASDH. Due to her advanced age and poor condition, we performed endoscopic surgery rather than craniotomy to evacuate the ASDH. Under local anesthesia, we made a burr hole in her left forehead and increased its size to 15 mm in diameter. After introducing a transparent sheath into the hematoma cavity with a rigid endoscope, the clot was evacuated with a suction tube. The arterial bleeding point was electrically coagulated. A postoperative CT scan confirmed the reduction of the hematoma. There was neither brain compression nor brain swelling. Her consciousness disturbance and right hemiplegia improved immediately. Endoscopic surgery may represent a viable method to address traumatic intracranial hematomas in some patients. PMID:24659965

Kon, Hiroyuki; Saito, Atsushi; Uchida, Hiroki; Inoue, Mizuho; Sasaki, Tatsuya; Nishijima, Michiharu

2013-09-01

74

Acute Spontaneous Posterior Fossa Subdural Hematoma  

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Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient?s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

Osama Shukir Muhammed Amin

2014-02-01

75

Acute subdural hematoma caused by clopidrogel  

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Full Text Available Clopidogrel, is a potent oral antiplatelet agent often used in the treatment of coronary artery disease, peripheral vascular disease, and cerebrovascular disease. Clopidrogel a thienopyridine deritivate, selectively inhibits the binding to adenosine diphosphate, thereby inhibiting platelet aggregation. It thus reduces the formation of arterial and venous thrombi. Reported side effects of clopidrogel include gastrointestinal symptoms of nausea, stomach ache, diarrhea, and constipation. Serious side effects consist of an increased risk of bleeding, intracranial hemorrhage, and severe neutropenia. A 75-year-old man with syncope was admitted to cardiology clinic. The patient had undergone two vessel angioplasty 15 years earlier. Furthermore, the patient had undergone placement of coronary artery stent 3 months earlier. His daily prescription contained clopidrogel 75 mg for the past 3 years. Fourteen hours after admittance to the cardiology clinic, the patient experienced a blackout. A computed tomography of the brain revealed acute subdural hematoma of the right frontoparietal region with 1.5 cm midline shift. The patient subsequently underwent right frontoparietal craniotomy with drainage of the subdural hematoma. Unfortunately, the patient died on the postoperative eleventh day.

Kaan ALTINKAYA

2010-01-01

76

Hematoma subdural em Pediatria Diagnosticar e tratar precocemente / Subdural hematoma in pediatrics - Early diagnosis and treatment  

Scientific Electronic Library Online (English)

Full Text Available Introdução: O hematoma subdural agudo não traumático é uma entidade rara em Pediatria. A presença de sintomas neuro­lógicos de instalação aguda associada a anticoagulação obriga à exclusão desta entidade. Caso clínico: Apresentamos o caso de uma criança, do sexo masculino, de sete anos de idade, com [...] prótese mitral mecâ­nica, medicada com varfarina, que recorreu ao serviço de urgência por cefaleias intensas e progressivas, associadas a alteração no estado de consciência e convulsões. A nível laboratorial o INR (In­ternational Normalized Ratio) era de 4,2. Foi admitida na Unidade de Cuidados Intensivos Pediátricos (UCIP) em coma com aniso­coria. Iniciou ventilação mecânica, medidas anti-edema cerebral e antiepilépticos.O exame de imagem mostrou hematoma subdural agudo à esquerda, com desvio da linha média. Foi submetida a craniotomia descompressiva, 56 horas após o início da sintomato­logia, com recuperação clínica e actualmente sem sequelas. Conclusão: Este caso clínico ilustra a importância da sus­peição clínica de hematoma subdural em doentes anticoagula­dos, bem como a necessidade de optimização das condições cirúrgicas e da utilização das técnicas não invasivas na monitori­zação do nível de consciência. Abstract in english Introduction: Non-traumatic acute subdural hematoma is a rare entity in children. In the presence of acute neurological symptoms associated with long termanticoagulation, it is manda­tory to rule out this entity. Case report: We report the case of a seven-year-old boy, with mechanical mitral valve p [...] rosthesis under warfarin treat­ment, presenting severe and progressive headache associated with altered level of consciousness and seizures. Laboratory studies revealed a high value of International Normalized Ratio(INR: 4,2). He was admitted to the Pediatric Intensive Care Unit in a coma with anisocoria. He was mechanically ventilated and started on specific measures to reduce cerebral edemain ad­dition to anticonvulsants. Cranial computerized tomography (CT scan) revealed acute left subdural hematoma, with midline shift. Fifty-six hours after the onset of symptoms, he was submitted to decompressive craniectomy. There was progressive clinical re­covery with neurological and imaging improvement and an excel­lent outcome. Discussion: This case illustrates the importance of the clinical suspicion of a subdural hematoma in patients treated with anticoagulants, as well as the need of optimizing surgical condi­tions and the use of non invasive techniques for monitoring the level of consciousness.

Marisa, Carvalho; Ema, Leal; Margarida, Santos; José, Ramos; Luís, Távora; Deolinda, Barata.

2011-06-01

77

Spontaneous resolution of nontraumatic acute spinal subdural hematoma.  

Science.gov (United States)

Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the condition is relieved with conservative treatment are rarely reported. We report two nontraumatic acute spinal subdural hematoma patients who were successfully treated without surgery. PMID:22102963

Yang, Na-Rae; Kim, Sang Jin; Cho, Yong Jae; Cho, Do Sang

2011-09-01

78

Presentación clínica del hematoma subdural crónico en adultos: el gran simulador Clínica del Hematoma Subdural Crónico  

Scientific Electronic Library Online (English)

Full Text Available Resumo Introdução: o hematoma subdural crônico (HSDC) é uma doença relativamente comum em adultos com mais de 60 anos. Sua apresentação clínica clássica é uma síndrome neurológica focal progressiva com sinais e sintomas de hipertensão endocraniana, em pacientes que de maneira geral tem antecedentes [...] de traumatismo craniano (TEC) nas duas ou três semanas anteriores à consulta. No entanto, o HSDC pode se apresentar sob diferentes formas o que dificulta seu diagnóstico. Material e métodos: são analisados os aspectos clínicos de 63 pacientes portadores de HSDC que consultaram no Hospital de Tacuarembó em um período de 59 meses. Resultados: os pacientes tinham entre 30 e 88 anos sendo 73% do sexo masculino; 67% tinham antecedentes de TEC. A apresentação mais freqüente foi um quadro progressivo de déficit focal ou hipertensão endocraniana. Em dois casos o déficit foi brusco, simulando um ataque cerebrovascular. Em três pacientes não havia registro de antecedente traumático e clinicamente se propôs um processo tumoral expansivo. Em 11 casos os sintomas iniciais foram da esfera neuropsíquica, simulando uma "demência". Em 18 casos houve depressão de vigília, sendo brusca em cinco, levando a proposição de um ataque cerebrovascular hemorrágico ou isquêmico. Em seis pacientes o sintoma mais destacado era cefaléia permanente sem outros sinais ou sintomas. Conclusões: a HSDC pode se apresentar com distintas "máscaras clínicas", simulando processos expansivos tumorais, ataques cerebrovasculares hemorrágicos ou isquêmicos, ataques isquêmicos transitórios ou demências. Em pessoas com mais de 60 anos com um quadro progressivo e de instalação insidiosa, mesmo com ausência de traumatismo craniano, deve-se suspeitar desta patologia. Abstract in spanish Introducción: el hematoma subdural crónico (HSDC) es una enfermedad relativamente común en mayores de 60 años. Su presentación clínica clásica es un síndrome neurológico focal progresivo con síntomas y signos de hipertensión endocraneana, en un paciente que generalmente tiene antecedentes de traumat [...] ismo craneano (TEC) al menos dos o tres semanas previas a la consulta. Sin embargo, el HSDC puede presentarse bajo diferentes formas clínicas que dificultan su diagnóstico. Material y método: se analizan los aspectos clínicos de 63 pacientes portadores de HSDC que consultaron en el Hospital de Tacuarembó en un período de 59 meses. Resultados: los pacientes tenían entre 30 y 88 años, 73% eran hombres. En 67% de los pacientes había antecedente de TEC. La forma de presentación más frecuente fue un cuadro progresivo de déficit focal o hipertensión endocraneana. En dos casos el déficit fue brusco, simulando un ataque cerebrovascular. En tres pacientes el antecedente traumático no fue recogido y se planteó clínicamente un proceso expansivo tumoral. En 11 casos los síntomas iniciales fueron de la esfera neuropsíquica, simulando una "demencia". En 18 casos hubo depresión de vigilia, siendo brusca en cinco de ellos, lo que llevó al planteo de ataque cerebrovascular hemorrágico o isquémico. En seis pacientes el síntoma cardinal era la cefalea permanente sin otros síntomas o signos. Conclusiones: el HSDC puede presentarse con distintas "máscaras clínicas", simulando procesos expansivos tumorales, ataques cerebrovasculares hemorrágicos o isquémicos, ataques isquémicos transitorios o demencias. Se debe entonces tener un alto índice de sospecha de esta enfermedad frente a individuos mayores de 60 años con un cuadro progresivo y de instalación insidiosa aun en ausencia de traumatismo de cráneo Abstract in english Summary Background: chronic subdural hematoma (CSDH-HSDC) is a relatively common disease in adults older than 60 years. The classic clinical presentation is a progressive focal neurologic syndrome with signs and symptoms of endocranial hypertension in patients that usually offer history of cranial t [...] raumatism (CT-TEC) of at least two or three weeks prior to consulting. Howe

Fernando, Martínez.

2007-06-01

79

Spontaneous Resolution of Nontraumatic Acute Spinal Subdural Hematoma  

OpenAIRE

Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the...

Yang, Na-rae; Kim, Sang Jin; Cho, Yong Jae; Cho, Do Sang

2011-01-01

80

Acute Cervical Spinal Subdural Hematoma Not Related to Head Injury  

OpenAIRE

We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural ...

Kim, Hee Yul; Ju, Chang Il; Kim, Seok Won

2010-01-01

81

Acute Spontaneous Spinal Subdural Hematoma with Vague Symptoms  

OpenAIRE

Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of ...

Chung, Jaehwan; Park, In Sung; Hwang, Soo-hyun; Han, Jong-woo

2014-01-01

82

Coagulação intravascular disseminada e hematoma subdural: relato de caso / Disseminated intravascular coagulation and subdural hematoma: a case report  

Scientific Electronic Library Online (English)

Full Text Available Os autores apresentam caso de hematoma subdural agudo, evacuado na presença de coagulopatia, e fazem considerações necessárias para a compreensão da etiopatogenia da enfermidade. [...] Abstract in english The authors present a case of acute subdural haematoma evacuated in the presence of a coagulopathy. Some elements necessary for the understanding of the etiopathogenesis of the disease are discussed. [...

C. E., Cavalcanti; E., Jansen.

1985-09-01

83

Coagulação intravascular disseminada e hematoma subdural: relato de caso Disseminated intravascular coagulation and subdural hematoma: a case report  

OpenAIRE

Os autores apresentam caso de hematoma subdural agudo, evacuado na presença de coagulopatia, e fazem considerações necessárias para a compreensão da etiopatogenia da enfermidade.The authors present a case of acute subdural haematoma evacuated in the presence of a coagulopathy. Some elements necessary for the understanding of the etiopathogenesis of the disease are discussed.

Cavalcanti, C. E.; Jansen, E.

1985-01-01

84

Coagulação intravascular disseminada e hematoma subdural: relato de caso Disseminated intravascular coagulation and subdural hematoma: a case report  

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Full Text Available Os autores apresentam caso de hematoma subdural agudo, evacuado na presença de coagulopatia, e fazem considerações necessárias para a compreensão da etiopatogenia da enfermidade.The authors present a case of acute subdural haematoma evacuated in the presence of a coagulopathy. Some elements necessary for the understanding of the etiopathogenesis of the disease are discussed.

C. E. Cavalcanti

1985-09-01

85

Spontaneous subdural hematoma in a young adult with hemophilia  

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Full Text Available We report a case of spontaneous acute subdural hematoma in a 30-year-old man, who was diagnosed with hemophilia during his hospital stay. He developed an extradural hematoma following evacuation of the acute SDH, which was also evacuated. He had a good outcome. Management of such a patient is discussed.

Agrawal D

2003-01-01

86

[An infant with acute subdural hematoma after a minor head injury associated with arachnoid cyst].  

Science.gov (United States)

A ten-month-old male infant fell onto the floor from a chair of 50 cm in height and hit his head on the day before hospitalization. He was admitted due to acute subdural hematoma, which was associated with arachnoid cyst. Head CT conducted on the 4th day confirmed that the hematoma had not enlarged. After discharge, enlargement of the hematoma was detected on MR imaging conducted on the 65th day after injury, followed by the diminution without surgical treatment. MR images were obtained on the 192nd day. In the case of head injury associated with arachnoid cyst, the risk of subdural hematoma as well as its ensuing enlargement in subacute or chronic phase needs to be considered. PMID:24620428

Kuniyoshi, Yasutaka; Kamura, Azusa; Yasuda, Sumie

2014-01-01

87

Hematoma subdural crónico calcificado. Reporte de un caso  

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Full Text Available El hematoma subdural crónico constituye una enfermedad frecuente en la práctica neuroquirúrgica cotidiana. Su diagnóstico se realiza actualmente de forma temprana en la mayoría de los pacientes, a partir de la introducción de las modernas técnicas de imagenología. Se presenta el caso de un enfermo de 84 años de edad con historia de cefalea, mutismo acinético y cuadriparesia, cuyo examen tomográfico mostró una colección extraxial supratentorial hemisférica derecha con calcificación masiva; se practicó la exéresis mediante una craneotomía y el estudio histopatológico confirmó el diagnóstico de hematoma subdural crónico. Se concluye que, al constituir la calcificación masiva del hematoma subdural crónico una rara forma de presentación imagenológica en la actualidad, deben contemplarse otras entidades en el diagnóstico diferencial como neoplasias y malformaciones vasculares intracraneales; por otro lado, aumenta la complejidad quirúrgica ya que es imprescindible la práctica de una craneotomía para la evacuación de la lesión.

Ariel Varela Hern\\u00E1ndez

2008-01-01

88

Rapid spontaneous resolution of an acute subdural hematoma: Case report  

International Nuclear Information System (INIS)

We present a case of acute subdural hematoma which was rapidly resolved without surgical intervention. This 31 year old man had a hematoma of which thickness was 9 mm and was paraplegic due to fracture-dislocation of thoracic spine at the level of TII-12 Rapid recovery of consciousness despite of sizable hematoma made to take a serial CT scanning instead of immediate surgical interventions. The hematoma was resolved within 4 hours without surgery. Possible mechanism of this rapid spontaneous resolution is discussed with brief review of the related literature

89

Enlarged cerebrospinal fluid spaces in infants with subdural hematomas  

International Nuclear Information System (INIS)

Computed tomography in 16 infants with subdural hematomas showed enlarged basal cisterns, a wide interhemispheric fissure, prominent cortical sulci, and varying degrees of ventricular enlargement. Radionuclide cisternography in eight of the 16 patients showed findings consistent with enlargement of the subarachnoid space rather than those of communicating hydrocephalus. Clinical findings and brief follow-up showed no convincing evidence for cerebral atrophy in 13 patients. These findings suggest that the enlarged subarachnoid space, which is encountered in some infants and may be a developmental variant, predisposes such infants to subdural hematomas

90

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage  

OpenAIRE

Objective. Subdural hygroma is reported to occur in 5%–20% of all patients with closed head trauma, the treatment is controversial and in symptomatic cases surgical drainage is need. We report on a new case with remote acute epidural hematoma (AEH) after subdural hygroma drainage. Case Presentation. A 38-year-old man suffered blunt head trauma and had diffuse axonal injury grade III in CT scan. A CT scan that was late performed showed an increasing subdural fluid collection with mild mass e...

Manoel Jacobsen Teixeira; Roger Schmidt Brock; Wellingson Silva Paiva; Arthur Maynart Pereira Oliveira; Almir Ferreira De Andrade

2010-01-01

91

Hematoma subdural crónico: Resultados quirúrgicos en 2 años de trabajo  

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Full Text Available Disminuir al máximo la mortalidad por hematoma subdural crónico (HSDC, es un reto que se debe alcanzar en todo centro neuroquirúrgico, en el que pueden influir el diagnóstico precoz y la adecuada selección del proceder quirúrgico. Se presentan 20 pacientes, 16 masculinos (80 % y 4 femeninos (20 %, con una edad promedio para el grupo de 66,55 años, tratados quirúrgicamente por medio de la trepanación múltiple con lavado de la cavidad y drenaje cerrado al exterior. La angiografía carotídea constituyó el examen más utilizado para el diagnóstico 14 (70 %, seguida por la tomografía axial computadorizada (TAC 8 (40 %. La escala de Bender se empleó para clasificar a los enfermos según el estado neurológico al ingreso, y se halló que el 80 % estaba en los grados I y II. Los resultados se evaluaron según la escala de resultados de Glasgow, y presentaron 17 (85 %, una buena recuperaciónTo reduce as much as possible mortality from chronic subdural hematoma (CSDH is a goal that should be attained by every neurosurgical center. An early diagnosis and an adequate selection of the surgical procedure may influence on it. 20 patients, 16 males (80 % and 4 females (20 % with an average age by group of 66.55 years of age were surgically treated by multiple trephining with lavage of the cavity and closed drainage. The carotid angiography was the most used test for the diagnosis with 14 (70 %, followed by computerized axial tomography (CAT with 8 (40 %. Bender´s scale was utilized to classify the patients according to the neurological state at the time of admission . 80 % of them corresponded to degrees I and II. The results were evaluated by using the Glasgow´s scale. 17 (85 % had a good recovery

Ángel Jesús Lacerda Gallardo

1999-04-01

92

Subdural Hematoma in Grave’s Disease Induced Thrombocytopenia.  

OpenAIRE

Subdural hematoma (SDH) usually occurs secondary to trauma, in bleeding disorders it may occur spontaneously. It is a rare complication of immune thrombocytopenia. Here we report a case of 45 years female presenting with presenting with complaints of headache, palpitation and menorrhagia and later diagnosed to be a case of Grave's disease with thrombocytopenia with sub dural hematoma. No such case reports are available in literature.

Sunil Kumar,; Sanjay Diwan; Shailee Chandek; Pratik Nitey; Anand Kakani

2013-01-01

93

Epstein-Barr virus-positive diffuse large B-cell primary central nervous system lymphoma associated with organized chronic subdural hematoma: A case report and review of the literature.  

Science.gov (United States)

We here report on a rare case of Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) detected in both brain parenchyma and in an organized chronic subdural hematoma (OCSH). A 96-year-old man diagnosed with asymptomatic OCSH in the left frontal convexity was referred to our hospital because of a de novo mass lesion just beneath the OCSH on contrast-enhanced magnetic resonance imaging. The size of the OCSH remained stable. We diagnosed the lesion as a malignant tumor. At surgery, the organized hematoma and the soft fragile tumor were removed. Histological examinations revealed pleomorphic lymphoid cells not only in the brain tissue but also in the OCSH component with tumor necrosis, and these were immunopositive for B-cell markers. In situ hybridization revealed positive signals for EBV-encoded small RNAs, consistent with EBV-positive DLBCL. Since the membranes of the subdural hematoma were fibrous and the tumor progression resulted in necrosis of the tumor, the DLBCL may have originally developed in the OCSH and infiltrated into the brain parenchyma. We believe that this rare case provides crucial information for the understanding of DLBCLs associated with OCSH. PMID:25597523

Kameda, Katsuharu; Shono, Tadahisa; Takagishi, Soh; Kono, Shinji; Aoki, Takatoshi; Ito, Yoshikiyo; Kamimura, Tomohiko; Sugita, Yasuo; Ohshima, Koichi

2015-03-01

94

Delayed post-operative contralateral epidural hematoma in a patient with right-sided acute subdural hematoma: a case report  

OpenAIRE

Head injury is one of the leading causes of death and disability in traumatic accidents. Post-operative contralateral epidural hematomas after surgery for acute subdural hematoma seem to be rare. In this case, expansion and spontaneous resolution of a fractural epidural hematoma contralateral to the side of acute subdural hematoma is presented. The importance of immediate post-operative computed tomography is also highlighted to detect delayed traumatic mass lesions.

Saberi, Hooshang; Meybodi, Ali Tayebi; Meybodi, Keyvan Tayebi; Habibi, Zohreh; Mirsadeghi, Sayed Mohammad Haji

2009-01-01

95

Spinal subdural hematoma as a complication of spinal surgery: can it happen without dural tear?  

OpenAIRE

Post spinal surgery subdural hematoma is a rare entity. This is a report of a case of acute post-operative spinal subdural hematoma, without any dural injury. The case was managed expectantly and went on to complete resolution of the hematoma and full clinical recovery.

Gakhar, Harinder; Bommireddy, Rajendranath; Klezl, Zdenek; Calthorpe, Denis

2012-01-01

96

Subdural Hematoma and Postdural Puncture Headache from Intrathecal Pump Placement Resolved with Lumbar Epidural Blood Patch  

OpenAIRE

Intrathecal drug delivery systems are commonly used in the management of chronic pain, cancer pain and neuromuscular disorders with muscle spasticity. The complications associated with in-trathecal pump placement include persistent cerebrospinal fluid (CSF) leak, hygroma, meningitis, and granuloma formation. A severe persistent CSF leak may cause postdural puncture headache along with acute intracranial subdural hematoma, which can be potentially life threatening. Surgical exploration with du...

Andrew Ng; Victor Romo; Dajie Wang

2014-01-01

97

Acute spontaneous spinal subdural hematoma with vague symptoms.  

Science.gov (United States)

Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis. PMID:25368774

Chung, Jaehwan; Park, In Sung; Hwang, Soo-Hyun; Han, Jong-Woo

2014-09-01

98

Unilateral optic neuropathy following subdural hematoma: a case report  

OpenAIRE

Abstract Introduction Unilateral optic neuropathy is commonly due to a prechiasmatic affliction of the anterior visual pathway, while losses in visual hemifields result from the damage to brain hemispheres. Here we report the unusual case of a patient who suffered from acute optic neuropathy following hemispherical subdural hematoma. Although confirmed up to now only through necropsy studies, our case strongly suggests a local, microcirculatory deficit identified through magnetic resonance im...

Witte Otto W; Fricke Hans-Joerg; Preul Christoph; Kretz Alexandra; Terborg Christoph

2010-01-01

99

Subdural Hematoma and Postdural Puncture Headache from Intrathecal Pump Placement Resolved with Lumbar Epidural Blood Patch  

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Full Text Available Intrathecal drug delivery systems are commonly used in the management of chronic pain, cancer pain and neuromuscular disorders with muscle spasticity. The complications associated with in-trathecal pump placement include persistent cerebrospinal fluid (CSF leak, hygroma, meningitis, and granuloma formation. A severe persistent CSF leak may cause postdural puncture headache along with acute intracranial subdural hematoma, which can be potentially life threatening. Surgical exploration with dural repair is required to treat this severe complication when conservative treatments fail. We present a case report of severe persistent CSF leak after intrathecal pump revision that resulted in a subdural hematoma and postdural puncture headache. In this case, an epidural blood patch was performed using epidural catheter under fluoroscopic guidance to target the site of CSF leak and to avoid damaging the intrathecal catheter. This patient’s headache was resolved and intrathecal catheter remained intact after this blood patch.

Andrew Ng

2014-09-01

100

Unoperated subdural hematomas. Long-term follow-up study by brain scan and electroencephalography  

International Nuclear Information System (INIS)

The authors report nine patients selected from over 100 patients with subdural hematomas successfully treated without surgery. These patients were followed for as long as 5 years. All had angiographically demonstrated subdural hematomas. Electroencephalograms (EEG) documented well the clinical improvement of the patient, but were poor guides to the true size of the hematoma, since EEG returns to normal early in the patient's course. Static scans are a better guide to the presence of a subdural hematoma, but they lag behind clinical improvement and usually remain abnormal for considerable periods of time after a major portion of the hematoma has been reabsorbed, and the patient is asymptomatic

101

Unilateral optic neuropathy following subdural hematoma: a case report  

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Full Text Available Abstract Introduction Unilateral optic neuropathy is commonly due to a prechiasmatic affliction of the anterior visual pathway, while losses in visual hemifields result from the damage to brain hemispheres. Here we report the unusual case of a patient who suffered from acute optic neuropathy following hemispherical subdural hematoma. Although confirmed up to now only through necropsy studies, our case strongly suggests a local, microcirculatory deficit identified through magnetic resonance imaging in vivo. Case presentation A 70-year-old Caucasian German who developed a massive left hemispheric subdural hematoma under oral anticoagulation presented with acute, severe visual impairment on his left eye, which was noticed after surgical decompression. Neurologic and ophthalmologic examinations indicated sinistral optic neuropathy with visual acuity reduced nearly to amaurosis. Ocular pathology such as vitreous body hemorrhage, papilledema, and central retinal artery occlusion were excluded. An orbital lesion was ruled out by means of orbital magnetic resonance imaging. However, cerebral diffusion-weighted imaging and T2 maps of magnetic resonance imaging revealed a circumscribed ischemic lesion within the edematous, slightly herniated temporomesial lobe within the immediate vicinity of the affected optic nerve. Thus, the clinical course and morphologic magnetic resonance imaging findings suggest the occurrence of pressure-induced posterior ischemic optic neuropathy due to microcirculatory compromise. Conclusion Although lesions of the second cranial nerve following subdural hematoma have been reported individually, their pathogenesis was preferentially proposed from autopsy studies. Here we discuss a dual, pressure-induced and secondarily ischemic pathomechanism on the base of in vivo magnetic resonance imaging diagnostics which may remain unconsidered by computed tomography.

Witte Otto W

2010-01-01

102

Positron emission tomography in the evaluation of subdural hematomas  

International Nuclear Information System (INIS)

Fifteen patients with 21 subdural effusions were investigated both with transmission computer assisted tomography (CAT) and positron emission tomography (PET). The tracer in the emission studies was 68Ga-EDTA. Twelve lesions were visualized both with CAT and PET. Five lesions that were negative or doubtful on CAT were visualized with PET, whereas four lesions negative or doubtful on PET were demonstrated by CAT. The two methods complement each other due to the fact that they are based on different mechanisms: CAT mainly on attenuation of the fluid collection. PET on isotope accumulation, particularly in the hematoma membranes

103

Spontaneous subdural hematoma of the thoracolumbar region with massive recurrent bleed  

OpenAIRE

Spinal subdural hematoma is a rare disorder and can be caused by abnormalities of coagulation, blood dyscrasias, lumbar puncture, trauma, underlying neoplasm, and arteriovenous malformation. We discuss an unusual case of an elderly woman who presented with spontaneous spinal subdural hematoma and developed massive rebleeding on the third day following initial evacuation of hematoma. This case illustrates that a patient with routine normal coagulation profile and adequate hemostasis can still ...

Cincu Rafael; Lorente Francisco de Asis; Rivero David; Eiras Jose; Ara Jose

2009-01-01

104

Sensitivity of radionuclide brain imaging and computerized transaxial tomography in detecting subdural hematoma  

International Nuclear Information System (INIS)

In a series of 23 patients with surgically proven subdural hematoma of durations ranging between two days to seven months, the detection rate of Tc-99m-pertechnetate brain imaging was higher than computerized transaxial tomography (CT). With dynamic perfusion scanning, the detection rate was 71.5%. In contrast, CT demonstrated the hematoma in 52% of the cases. Lastly, the result of CT scanning was dependent on the size of the subdural hematoma as evaluated at the time of operation

105

A Case of Dural Arteriovenous Fistula Presenting as Acute Subdural Hematoma  

OpenAIRE

Dural arteriovenous fistula (AVF) presenting with subdural hematoma is relatively rare. We report a case of dural AVF presenting as acute subdural hematoma (ASDH) and provide a review of the literature. A 56-year-old man presented with disturbance of consciousness. Computed tomography demonstrated a right ASDH and a small right occipital subcortical hematoma. Cerebral angiography showed a dural AVF on the occipital convexity draining into the cortical veins. Emergent endovascular embolization...

Saito, Atsushi; Kawaguchi, Tomohiro; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

106

Spontaneous acute subdural hematoma contralateral to an arachnoid cyst Hematoma subdural agudo espontâneo contralateral a cisto aracnóideo  

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Full Text Available Arachnoid cysts (AC are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%. More than 25% of these cysts are incidental findings and the majority of patients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.Os cistos aracnóideos (CA são coleções liquóricas extra-cerebrais e intra-aracnóideas de origem desconhecida. Correspondem a 1% de todas as lesões expansivas intracranianas não traumáticas e têm nítido predomínio na fossa média (50%. Até 25% destes cistos são achados incidentais sendo que a maioria dos pacientes é assintomática. Crises epilépticas, sinais de hipertensão intracraniana, déficits neurológicos focais, macrocrania, atraso no desenvolvimento e abaulamento da calota craniana são os principais sinais e sintomas da lesão. A ruptura dos CA, assim como seu sangramento, são situações raras, geralmente associadas a traumas e acometem adultos jovens. O risco de hemorragia em pacientes com CA não excede 0,04% ao ano. É descrito caso de paciente de dez anos de idade que subitamente apresentou sinais de hipertensão intracraniana secundários a hematoma subdural agudo espontâneo, contralateral a volumoso CA de fossa média. Três fatores foram de relevância neste paciente: a ocorrência de sinais e sintomas espontaneamente, especialmente em um menino; presença de hematoma subdural agudo exclusivamente contralateral ao CA; e a boa evolução com o tratamento conservador.

José Gilberto de Brito Henriques

2007-12-01

107

Subdural hematoma caused by epithelioid angiosarcoma originating from the skull.  

Science.gov (United States)

Cancers metastatic to the skull or dura may cause subdural hematoma (SDH). However, the frequency is low, and the presence of underlying cancers has almost always been known in such situations. We report a case of skull angiosarcoma manifesting as SDH, posing a diagnostic challenge to physicians. A 75-year-old man visited our clinic with sensorimotor disturbance of gradual onset approximately 1 month after a minor head trauma. He was diagnosed with SDH after imaging studies, and underwent surgery to evacuate the hematoma. Because the hematoma was organized, surgery was switched from burr-hole drainage to craniotomy. The bone flap as well as the dura over the hematoma had grossly normal appearance, and only the hematoma itself was submitted for histological examination. Although postoperative recovery was uneventful, the patient experienced recurrence of the SDH 2 months after surgery. At the second surgery, the bone flap and dura were intermingled with tumor tissue, and histological examination revealed that an epithelioid angiosarcoma originating from the skull was responsible for the SDH. Timely diagnosis of angiosarcoma manifesting as SDH is difficult because of its rarity. In retrospect, however, the diagnosis might have been established earlier if the bone flap and/or the dura had been biopsied at the time of the first surgery. The present case gives us a lesson that SDH may be an unusual manifestation of malignant tumors of skull or dural origin, and histological examination of not only hematoma capsule but also of the surrounding tissues may provide important diagnostic clues. PMID:22843419

Yamada, Yasuhiro; Inamasu, Joji; Moriya, Shigeta; Oguri, Daikichi; Hasegawa, Mitsuhiro; Abe, Masato; Hirose, Yuichi

2013-06-01

108

Biomechanical analysis of acute subdural hematoma resulting from judo.  

Science.gov (United States)

This study investigated biomechanical mechanisms of acute subdural hematoma caused by judo and sought preventive measures to reduce injury. A Japanese judo expert repeatedly threw an anthropometric test device using two throwing techniques, Osoto-gari and Ouchi-gari. Linear and angular accelerations of the head were measured. Both throwing techniques resulted in the dummy falling backwards, with the occipital area of the head contacting the mat, and peak linear and angular accelerations being observed when the head contacted the mat. For linear acceleration, the posterior-anterior direction showed the greatest force (41.0 ± 2.6 G using Osoto-gari, and 86.5 ±4.3 G using Ouchi-gari). For angular acceleration, values for sagittal plane rotation were greatest among the three directions measured (3315 ± 168 rad/s(2) using Osoto-gari, and 1328 ± 201 rad/s(2) using Ouchi-gari). We concluded that occipital head contact produced the most forceful longitudinal linear and sagittal plane angular accelerations; subsequent stretches and ruptures of parasagittal bridging veins resulting in acute subdural hematoma. As severe head injuries can result if a person's head comes into contact with the mat, offensive throwing techniques should be restricted to participants able to sufficiently demonstrate the Ukemi technique. PMID:25355441

Hitosugi, Masahito; Murayama, Haruo; Motozawa, Yasuki; Ishii, Kanto; Ogino, Masahiro; Koyama, Katsuhiro

2014-01-01

109

Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso Hematoma subdural intracraneal: una rara complicación después de la raquianestesia: relato de caso Intracranial subdural hematoma: a rare complication following spinal anesthesia: case report  

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Full Text Available JUSTIFICATIVA E OBJETIVOS: O hematoma subdural intracraniano é uma complicação rara após raquianestesia. O diagnóstico é muitas vezes difícil porque os sintomas iniciais são os mesmos da cefaleia pós-punção da dura-máter. O objetivo é relatar o caso de um hematoma subdural diag nosticado precocemente, após uma raquianestesia realizada com agulha de calibre fino e punção única. RELATO DO CASO: Paciente de 48 anos, ASA I, submetida a raquianestesia para cirurgia de correção de incontinência urinária. Foi realizada a raquianestesia com agulha 27G Quincke e punção única. A cirurgia foi sem intercorrências, e a paciente recebeu alta hospitalar. Após 48 horas da punção raquidiana, a paciente relatou cefaleia de início súbito, de forte intensidade, acometendo principalmente a região orbitária, mas também a região temporal, com melhora importante no decúbito dorsal e acompanhada de dois episódios de vômitos. Foi solicitada tomografia de crânio que revelou a presença de um hematoma subdural agudo frontotemporoparietal esquerdo. Foi indicado tratamento conservador com analgésicos, dexametasoma e hidantoína. Após 17 dias, apresentou quadro de cefaleia intensa, acompanhada de dormência e paresia do membro superior direito, e distúrbio da fala e comportamento. O hematoma foi drenado cirurgicamente. A paciente evoluiu bem sem sequelas. CONCLUSÕES: A cefaleia é a complicação mais frequente após raquianestesia e é considerada de evolução benigna. Faz com que diagnósticos potencialmente fatais, como o hematoma subdural, não sejam feitos em muitos casos, ou sejam tardios. Este caso descreve uma ocorrência rara, um hematoma subdural agudo após uma raquianestesia com agulha fina em uma paciente sem fatores de risco para sangramentoJUSTIFICATIVA Y OBJETIVOS: El hematoma subdural intracraneal es una complicación rara posterior a la raquianestesia. El diagnóstico es en muchas ocasiones difícil, porque los síntomas iniciales son los mismos de la cefalea postpunción de la duramadre. El objetivo de este estudio, es relatar el caso de un hematoma subdural diagnosticado rápidamente, y posterior a una raquianestesia realizada con una aguja de calibre fino y punción única. RELATO DEL CASO: Paciente de 48 años, ASA I, sometida a la raquianestesia para la cirugía de corrección de incontinencia urinaria. Fue realizada la raquianestesia con una aguja 27G Quincke y una punción única. La cirugía transcurrió sin problemas, y la paciente recibió alta. Después de 48 horas de efectuada la punción raquídea, la paciente relató cefalea de inicio súbito, de fuerte intensidad, afectando principalmente la región orbitaria, pero también la región temporal, con una mejoría importante en el decúbito dorsal, y acompañada de dos episodios de vómitos. Se le solicitó la tomografía de cráneo que arrojó un hematoma subdural agudo frontotemporoparietal izquierdo. Fue indicado un tratamiento conservador con analgésicos, dexametasoma e hidantoína. Después de 17 días, debutó con un cuadro de cefalea intensa, seguida de adormecimiento y paresia del miembro superior derecho, y un disturbio del habla y del comportamiento. El hematoma fue drenado quirúrgicamente. La paciente evolucionó bien y sin secuelas. CONCLUSIONES: La cefalea es la complicación más frecuente después de la raquianestesia y se le considera de evolución benigna. Ella logra que diagnósticos potencialmente fatales, como el hematoma subdural, se eviten en muchos casos o se hagan más tarde. Este caso describe una aparición rara, un hematoma subdural agudo posterior a una raquianestesia con una aguja fina en una paciente sin factores de riesgo para el sangramientoBACKGROUND AND OBJECTIVES: Intracranial subdural hematoma is a rare complication following spinal anesthesia. The diagnosis is usually difficult because initial symptoms are the same of post-dural puncture headache. The objective was to report a case of early diagnosed subdural hematoma after spinal anesthesia performed with a fine-gauge ne

Flora Margarida Barra Bisinotto

2012-02-01

110

Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso / Intracranial subdural hematoma: a rare complication following spinal anesthesia: case report / Hematoma subdural intracraneal: una rara complicación después de la raquianestesia: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available JUSTIFICATIVA E OBJETIVOS: O hematoma subdural intracraniano é uma complicação rara após raquianestesia. O diagnóstico é muitas vezes difícil porque os sintomas iniciais são os mesmos da cefaleia pós-punção da dura-máter. O objetivo é relatar o caso de um hematoma subdural diag nosticado precocement [...] e, após uma raquianestesia realizada com agulha de calibre fino e punção única. RELATO DO CASO: Paciente de 48 anos, ASA I, submetida a raquianestesia para cirurgia de correção de incontinência urinária. Foi realizada a raquianestesia com agulha 27G Quincke e punção única. A cirurgia foi sem intercorrências, e a paciente recebeu alta hospitalar. Após 48 horas da punção raquidiana, a paciente relatou cefaleia de início súbito, de forte intensidade, acometendo principalmente a região orbitária, mas também a região temporal, com melhora importante no decúbito dorsal e acompanhada de dois episódios de vômitos. Foi solicitada tomografia de crânio que revelou a presença de um hematoma subdural agudo frontotemporoparietal esquerdo. Foi indicado tratamento conservador com analgésicos, dexametasoma e hidantoína. Após 17 dias, apresentou quadro de cefaleia intensa, acompanhada de dormência e paresia do membro superior direito, e distúrbio da fala e comportamento. O hematoma foi drenado cirurgicamente. A paciente evoluiu bem sem sequelas. CONCLUSÕES: A cefaleia é a complicação mais frequente após raquianestesia e é considerada de evolução benigna. Faz com que diagnósticos potencialmente fatais, como o hematoma subdural, não sejam feitos em muitos casos, ou sejam tardios. Este caso descreve uma ocorrência rara, um hematoma subdural agudo após uma raquianestesia com agulha fina em uma paciente sem fatores de risco para sangramento Abstract in spanish JUSTIFICATIVA Y OBJETIVOS: El hematoma subdural intracraneal es una complicación rara posterior a la raquianestesia. El diagnóstico es en muchas ocasiones difícil, porque los síntomas iniciales son los mismos de la cefalea postpunción de la duramadre. El objetivo de este estudio, es relatar el caso [...] de un hematoma subdural diagnosticado rápidamente, y posterior a una raquianestesia realizada con una aguja de calibre fino y punción única. RELATO DEL CASO: Paciente de 48 años, ASA I, sometida a la raquianestesia para la cirugía de corrección de incontinencia urinaria. Fue realizada la raquianestesia con una aguja 27G Quincke y una punción única. La cirugía transcurrió sin problemas, y la paciente recibió alta. Después de 48 horas de efectuada la punción raquídea, la paciente relató cefalea de inicio súbito, de fuerte intensidad, afectando principalmente la región orbitaria, pero también la región temporal, con una mejoría importante en el decúbito dorsal, y acompañada de dos episodios de vómitos. Se le solicitó la tomografía de cráneo que arrojó un hematoma subdural agudo frontotemporoparietal izquierdo. Fue indicado un tratamiento conservador con analgésicos, dexametasoma e hidantoína. Después de 17 días, debutó con un cuadro de cefalea intensa, seguida de adormecimiento y paresia del miembro superior derecho, y un disturbio del habla y del comportamiento. El hematoma fue drenado quirúrgicamente. La paciente evolucionó bien y sin secuelas. CONCLUSIONES: La cefalea es la complicación más frecuente después de la raquianestesia y se le considera de evolución benigna. Ella logra que diagnósticos potencialmente fatales, como el hematoma subdural, se eviten en muchos casos o se hagan más tarde. Este caso describe una aparición rara, un hematoma subdural agudo posterior a una raquianestesia con una aguja fina en una paciente sin factores de riesgo para el sangramiento Abstract in english BACKGROUND AND OBJECTIVES: Intracranial subdural hematoma is a rare complication following spinal anesthesia. The diagnosis is usually difficult because initial symptoms are the same of post-dural puncture headache. The objective was to report a case of early diagnosed subdural hematoma

Flora Margarida Barra, Bisinotto; Roberto Alexandre, Dezena; Daniel Capucci, Fabri; Tania Mara Vilela, Abud; Livia Helena, Canno.

2012-02-01

111

Meningioma associated with acute subdural hematoma: A review of the literature  

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Background: Classically meningiomas present with a gradual onset of symptoms and their acute presentation with hemorrhagic events seems to be a rare event. A review of the literature shows only 18 cases of meningioma associated with acute subdural hematoma. The possible mechanisms of hemorrhage are not yet fully understood. Case Description: We report a case of sphenoid wing meningioma associated with acute subdural hematoma, without history of trauma. The presence of meningioma was discovered during the surgery. The tumor and hematoma were removed without postoperative complications. Conclusions: The authors have discussed the etiology of an acute subdural hemorrhage and reviewed the pertinent literature. PMID:25422791

Hambra, Di Vitantonio; Danilo, De Paulis; Alessandro, Ricci; Sara, Marzi; Juan, Galzio Renato

2014-01-01

112

HEMATOMA SUBDURAL EN PACIENTE CON LEUCEMIA MIELODE CRONICA: REPORTE DE CASO  

OpenAIRE

El hematoma subdural cronico se define como una colección sanguíneo fibrinoide en el espacio existente entre las meninges duramadre y aracnoides, debido a traumas, infecciones (empiema y meningitis), coagulopatías u otras causas. En este se puede precisar durante la intervención quirúrgica la presencia de cápsula o membranas. Entre las diversas causas de hematoma subdural crónico se encuentra la leucemia mieloide crónica que es un síndrome mieloproliferativo, donde se ve una acentuad...

Carlos Fernando Lozano-Tangua; Luis Rafael Moscote-Salazar; Gabriel Alcala-Cerra; Sandra Milena Castellar Leones; Diego Batero

2009-01-01

113

Spontaneous acute subdural hematoma as an initial presentation of choriocarcinoma: A case report  

OpenAIRE

Abstract Introduction Diverse sequelae of central nervous system metastasis of choriocarcinoma have been reported, including infarction, intra or extra axial hemorrhages, aneurysm formation and carotid-cavernous fistula. Here we report a case of subdural hematoma as the first presentation of choriocarcinoma. Case presentation The patient is a 34-year-old woman whose initial presentation of widely metastatic choriocarcinoma was an acute subdural hematoma, requiring decompressive craniectomy. H...

Rocque Brandon G; Ba?kaya Mustafa K

2008-01-01

114

Brain herniation induced by drainage of subdural hematoma in spontaneous intracranial hypotension  

OpenAIRE

Spontaneous intracranial hypotension (SIH), typically presents with orthostatic headache, low pressure on lumbar tapping, and diffuse pachymeningeal enhancement on magnetic resonance imaging. SIH is often accompanied by subdural fluid collections, which in most cases responds to conservative treatment or spinal epidural blood patch. Several authors advocate that large subdural hematoma with acute deterioration merits surgical drainage; however, few have reported complications following cranio...

Chotai, Silky; Kim, Jong-hyun; Kim, Joo-han; Kwon, Taek-hyun

2013-01-01

115

Spontaneous subdural hematoma of the thoracolumbar region with massive recurrent bleed  

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Full Text Available Spinal subdural hematoma is a rare disorder and can be caused by abnormalities of coagulation, blood dyscrasias, lumbar puncture, trauma, underlying neoplasm, and arteriovenous malformation. We discuss an unusual case of an elderly woman who presented with spontaneous spinal subdural hematoma and developed massive rebleeding on the third day following initial evacuation of hematoma. This case illustrates that a patient with routine normal coagulation profile and adequate hemostasis can still harbor platelet dysfunction (in present case due to polycythemia and later on can manifest as rebleeding and neurological deterioration.

Cincu Rafael

2009-01-01

116

Non-surgical management of intracranial subdural hematoma complicating spinal anesthesia / Manejo no quirúrgico de hematoma subdural intracraneal tras anestesia espinal complicada  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish El hematoma subdural (SDH) es una complicación evolutiva rara, documentada y de riesgo vital en los cuadros de cefalea post punción subdural (PDPH). Presentamos un caso de esta rara complicación resuelto con un parche de sangre autóloga epidural y tratamiento conservador, sin precisar evacuación qui [...] rúrgica. Abstract in english We report the case of a 29 year-old woman who presented a symptomatic intracranial subdural hematoma developing shortly after spinal anesthesia. The patient was fully conscious at clinical onset, and thus we treated her conservatively with an epidural autologous blood patch and close neurological ob [...] servation. Given the clinical improvement the possibility of surgery was discauded in agreement with the neurosurgical team. Most cases of subdural hematoma appearing after spinal anesthesia are treated with surgery. In the present case the subdural hemorrhage was detected at our hospital 20 days after the anesthetic procedure, and given the excellent state of consciousness, we choosed a conservative management.

M.T., Verdú; J.F., Martínez-Lage; B., Alonso; J.L., Sánchez-Ortega; A., Garcia-Candel.

2007-02-01

117

Posttraumatic retroclival acute subdural hematoma: Report of two cases and review of literature  

OpenAIRE

Traumatic retroclival hematomas are uncommon lesions usually associated with significant trauma. Majority of the reported hematomas are epidural; and in the pediatric population. Retroclival acute subdural hematomas (RSDH) are very rare, with only two previous cases reported in English literature. An 18-year-old man presented with headache and no deficits following an accident. Computer tomography (CT) scan and magnetic resonance imaging (MRI) showed an acute RSDH extending into the spinal su...

Sridhar Krishnamurthy; Venkateswara Prasanna; Ramakrishnaiah Sridhar; Iyer Vijay

2010-01-01

118

Hematoma subdural de medula espinhal associada ao uso de anticoagulante oral Hematoma subdural de la médula espinal asociado al uso de anticoagulante oral Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA)  

OpenAIRE

O hematoma subdural de medula espinhal (HSDME) é uma complicação rara decorrente do uso de antagonistas de vitamina K (AVK) e de diagnostico difícil. Este artigo apresenta um caso com complicação ameaçadora à vida: um paciente octogenário portador de fibrilação atrial de início recente em uso de AVK. A história e o exame físico inicialmente se apresentavam normais, associados com a elevação dos valores de coagulograma supraterapêuticos (INR > 10). Após 24 horas da admissão ...

Uri Adrian Prync Flato; Paulo Sérgio Rheder; Helio Penna Guimarães; Elias Silva Flato; Paulo Cretella

2009-01-01

119

Hematoma subdural agudo traumático: estudo de 110 pacientes Acute traumatic subdural haematomas: study of 110 cases  

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Full Text Available Apresentamos uma série consecutiva de 110 pacientes com hematoma subdural agudo traumático (HSDA admitidos no serviço de emergência do HBDF no período de 1°-janeiro a 1°-dezembro-1994. Todos os pacientes foram atendidos de acordo com o mesmo protocolo. Houve predominância do sexo masculino (79%, com idade variando entre 14 e 70 anos, sendo os atropelamentos (34% e os acidentes automobilísticos (20% as causas mais comuns. A maioria dos pacientes (85,7% foi admitida muito grave, com 8 pontos ou menos na Escala de Coma Glasgow (ECG, o que influenciou diretamente na mortalidade. A tomografia computadorizada de crânio foi o exame diagnóstico de escolha que mostrou serem as contusões e o inchaço cerebral ("swelling" as lesões intracranianas associadas mais freqüentes. A cirurgia foi realizada em 45,1% dos pacientes, e, em sua maioria, através de craniotomia fronto-têmporo-parietal ampla, com drenagem do hematoma, seguida de plástica da dura-mater. Em 54,9% as condições clínicas não permitiram a realização da cirurgia; neste grupo, cerca de 69,6% estavam em coma profundo à admissão, com 3 pontos na ECG. A letalidade cirúrgica foi de 61,2% e esteve diretamente relacionada à condição clínica inicial e à idade do paciente. A letalidade, incluindo todos os pacientes cirúrgicos e não cirúrgicos com HSDA, mesmo aqueles admitidos já com sinais de falência de tronco cerebral, foi de 79,5%. Além destes pacientes que faleceram, cerca de 7% evoluíram sem seqüelas ou com seqüelas mínimas; outros 11,4% com seqüelas de moderadas a paves e 2,1 % permaneceram em estado vegetativo persistente. Nossos dados estão de acordo com os da literatura no que se refere a elevada taxa de morbidade e mortalidade dos pacientes com HSDA.We report a series of 110 patients with acute traumatic subdural hematoma (ASDH admitted at HBDF emergency within 1994 (January Is1 to December PJ.All patients were treated according to the same protocol. There was a predominance of males (79%, with ages ranging from 14 to 70, being car accidents (20% and car-pedestrian accidents (34% the most frequent causes The majority of patients (85.7% was admitted in very serious condition, with a score of 8 points on the Glasgow Coma Scale (GCS or lesser, which directly influenced the mortality rates. CT scan was the diagnostic procedure of choice, and it showed contusion and brain swelling to be the most frequent associated intracranial lesions. Surgery was carried out in 45.1% of cases and, in most instances, through an ample fronto-temporo-parietal craniotomy, with hematoma drainage and dural reconstitution. In 54.9% of cases, clinical conditions did not allow surgery and in this group, 69.6%

Nicandro de Figueiredo Neto

1996-06-01

120

Re-estimation of acute subdural hematoma in children caused by trivial household head trauma  

International Nuclear Information System (INIS)

The objective of this study was to identify characteristics of acute subdural hematoma in children caused by a trivial household head trauma from a modem neurosurgical and medicolegal standpoint. We performed a retrospective study of 25 children younger than 48 months hospitalized for acute subdural hematoma from December 1, 1993, through February 28, 2003. Inclusion criteria were as follows: acute subdural hematoma caused by trivial household trauma and a history of trauma corroborated by a caretaker, absence of physical injuries consistent with child abuse, fundoscopic examinations performed by a pediatric ophthalmologist, absence of fractures on general bone survey, and child abuse ruled out by long-term follow-up (more than 5 years). Twenty-one of the patients were boys, and 4 were girls. The patients ranged in age from 6 to 17 months, with an average age of 8.5 months. In 17 of 25 patients trauma had been caused by falls to the floor while standing with support or while sitting. Most of the patients were admitted to the hospital because of generalized convulsions or seizures that had developed soon after a trivial household trauma. Fifteen of the 25 (60%) patients had retinal or preretinal hemorrhage and 9 patients had bilateral retinal hemorrhage. Computed tomography showed fluid-type acute subdural hematomas at the frontal convexity or in the interhemispheric fissure in 18 of 25 (72%) patients. Fourteen of 25 (56%) patients had pre-existing external hydrocephalents had pre-existing external hydrocephalus (enlargements of the subarachnoid space). The long-term outcomes included normal mental development (IQ?80) in 18 cases, mild mental retardation (IQ<80) in 7 cases, and epilepsy in 3 cases. Acute subdural hematoma in children caused by trivial household trauma is a clinical entity distinct from acute subdural hematoma caused by child abuse or shaken-baby syndrome. (author)

121

[Spontaneous resolution of idiopathic spinal subdural hematoma: case report].  

Science.gov (United States)

A 32-year-old female presented with about a week's history of dull pain in the head and neck pain. On the day of admission, she experienced a sudden onset of severe pain, extending from the occipital to the lower back region and hypesthesia and paresthesia of the right C8-Th3 dermatome. On admission, she was alert but there was a band of hypesthesia and paresthesia at the level of C8-Th3. Cervical X-ray, computed tomography scan (CT) and magnetic resonance images (MRI) of the head revealed no definite abnormalities. The peripheral blood picture was normal, and the bleeding and clotting times were in the normal range. The cerebrospinal fluid (CSF) was bloody and the CSF pressure was 220 mm H2O. An emergent 4-vessel intracranial angiography disclosed no abnormal findings. MRI and myelography revealed an intradural extramedullary lesion extending from the Th2 to the Th5 levels, ventral to the spinal cord. A T1-weighted MR image showed iso-low intensity and a T2-weighted MR image showed low intensity at these lesions. Spinal angiography revealed no abnormal vessels. In one month, spinal compression cleared gradually without surgery and her clinical symptoms disappeared about 40 days after admission. Spontaneous spinal subdural hematoma is uncommon and only 28 cases have been reported. 15 cases have been treated with surgical procedure, but spinal compression cleared spontaneously in this case. This spontaneous recovery is such a rare event that only 3 such cases have been reported in the literature. However, with the prevailing MRI, this disease will be detected more frequently in the future. PMID:9834497

Tamano, Y; Iwata, Y; Baba, M; Izawa, M; Takakura, K

1998-11-01

122

HEMATOMA SUBDURAL EN PACIENTE CON LEUCEMIA MIELODE CRONICA: REPORTE DE CASO  

Directory of Open Access Journals (Sweden)

Full Text Available El hematoma subdural cronico se define como una colección sanguíneo fibrinoide en el espacio existente entre las meninges duramadre y aracnoides, debido a traumas, infecciones (empiema y meningitis, coagulopatías u otras causas. En este se puede precisar durante la intervención quirúrgica la presencia de cápsula o membranas. Entre las diversas causas de hematoma subdural crónico se encuentra la leucemia mieloide crónica que es un síndrome mieloproliferativo, donde se ve una acentuada proliferación de glóbulos blancos de la serie granulocítica, que infiltran la sangre, médula ósea, cerebro entre otros tejidos. Presentamos brevemente un caso de esta interesante y no infrecuente asociación.

Carlos Fernando Lozano-Tangua

2009-01-01

123

Posttraumatic retroclival acute subdural hematoma: Report of two cases and review of literature  

Directory of Open Access Journals (Sweden)

Full Text Available Traumatic retroclival hematomas are uncommon lesions usually associated with significant trauma. Majority of the reported hematomas are epidural; and in the pediatric population. Retroclival acute subdural hematomas (RSDH are very rare, with only two previous cases reported in English literature. An 18-year-old man presented with headache and no deficits following an accident. Computer tomography (CT scan and magnetic resonance imaging (MRI showed an acute RSDH extending into the spinal subdural space. He developed bilateral sixth nerve palsies, with symptoms of raised intracranial pressure within the next 24 hours. He underwent evacuation of hematoma with a good outcome. Another 19-year-old man presented with neck pain following a fall from a moving bus. He had no neurological deficits. CT scan showed a RSDH extending across the craniovertebral junction. He was managed conservatively with good outcome.

Sridhar Krishnamurthy

2010-01-01

124

A case of dural arteriovenous fistula presenting as acute subdural hematoma.  

Science.gov (United States)

Dural arteriovenous fistula (AVF) presenting with subdural hematoma is relatively rare. We report a case of dural AVF presenting as acute subdural hematoma (ASDH) and provide a review of the literature. A 56-year-old man presented with disturbance of consciousness. Computed tomography demonstrated a right ASDH and a small right occipital subcortical hematoma. Cerebral angiography showed a dural AVF on the occipital convexity draining into the cortical veins. Emergent endovascular embolization was immediately performed and the shunt flow disappeared. Hematoma removal and external decompression were safely conducted. Combined therapy successfully recovered the patient's consciousness level. This rare case of dural AVF presenting with ASDH was treated with combined treatments of endovascular and open surgery. PMID:24926261

Saito, Atsushi; Kawaguchi, Tomohiro; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

125

Spinal subdural hematoma revealing hemophilia A in a child: A case report  

OpenAIRE

Abstract Background Intraspinal bleeding especially in the form of subdural hematoma is rare in hemophiliacs. In the present case, we report a neglected hemophilic A child with such a problem and discuss its management options. Case Presentation A 9-year old hemophilic A boy presented with quadriparesis, confusion and meningismus after a fall 4 days previously. There was no sign of direct trauma to his back. His CT Scan and MRI showed spinal extramedullary hematoma extended from C5 to L2. We...

Bakhtiari Abbas; Ketabchi Ebrahim; Ghodsi Mohammad; Eftekhar Behzad; Mostajabi Pardis

2003-01-01

126

Decompression hyperostosis: cranial hyperostosis mimicking bilateral subdural hematoma on brain scintigraphy  

International Nuclear Information System (INIS)

Scintigraphic findings suggestive of bilateral subdural hematoma developed after successful decompression of communicating hydrocephalus. These findings were secondary to cranial hyperostosis. The similarity of brain scintigraphic findings in the two disorders is pointed out, and the necessity of correlating brain scintigraphs with skull radiographs is stressed. (U.S.)

127

Safe Implementation of Mechanical Thrombectomy in Acute Stroke Patients with Major Arterial Occlusion and Concomitant Subdural Hematoma  

OpenAIRE

Mechanical thrombectomy (MT) alone in cases of large-vessel acute ischemic stroke (AIS) with a concomitant subdural hematoma (SDH) seems feasible and safe, but there's still a lack of evidence in the clinical literature. We report three cases of AIS with SDH, of which MT was performed with successful recanalization and no major changes in SDH: two elderly men with acute traumatic SDH and one man with incidental chronic SDH. (1) A 67-year-old man with acute traumatic SDH in the right side deve...

Kim, Yong-won; Kang, Dong-hun; Hwang, Yang-ha; Kim, Yong-sun; Park, Sung-pa

2013-01-01

128

Management of Patients Presenting with Acute Subdural Hematoma due to Ruptured Intracranial Aneurysm.  

Science.gov (United States)

Acute subdural hematoma is a rare presentation of ruptured aneurysms. The rarity of the disease makes it difficult to establish reliable clinical guidelines. Many patients present comatose and differential diagnosis is complicated due to aneurysm rupture results in or mimics traumatic brain injury. Fast decision-making is required to treat this life-threatening condition. Determining initial diagnostic studies, as well as making treatment decisions, can be complicated by rapid deterioration of the patient, and the mixture of symptoms due to the subarachnoid hemorrhage or mass effect of the hematoma. This paper reviews initial clinical and radiological findings, diagnostic approaches, treatment modalities, and outcome of patients presenting with aneurysmal subarachnoid hemorrhage complicated by acute subdural hematoma. Clinical strategies used by several authors over the past 20 years are discussed and summarized in a proposed treatment flowchart. PMID:22500234

Marbacher, Serge; Tomasi, Ottavio; Fandino, Javier

2012-01-01

129

Hemorrhagic lumbar facet cysts accompanying a spinal subdural hematoma at the same level.  

Science.gov (United States)

Context We present a rare and interesting case of hemorrhagic lumbar facet cysts accompanying a spinal subdural hematoma at the same level suggesting a possible mechanism by which spinal subdural hematomas can arise. Findings A 71-year-old man presented with persistent sciatic pain and intermittent claudication. Magnetic resonance imaging demonstrated a multilocular mass lesion that showed high signal intensity in both T1- and T2-weighted images, and was located both inside and outside of the spinal canal. Computed tomographic myelography showed a cap-shaped block of the dural tube at L5 and computed tomography with L5-S facet arthrography demonstrated cystic masses. The patient was diagnosed with lumbar radiculopathy caused by hemorrhagic facet cysts, and then progressed to surgical treatment. Surgery revealed that the cysts contained blood clots, and intraoperative findings that the inside of the dural tube appeared blackish and that the dural tube was tensely ballooned after removal of the cysts led us to explorative durotomy. The durotomy demonstrated concentrated old blood pooling both in the dorsal and ventral subdural space, and these spaces were subsequently drained. After surgery, his sciatic pain and intermittent claudication resolved. There was no evidence of cyst mass recurrence at 2 years of follow-up. Conclusion We propose a newly described mechanism for the formation of spinal subdural hematomas. We recommend surgeons be alert to epidural lesions causing repeated acute compression of the dural tube, which can cause spinal subdural hematoma, and consider the possible coexistence of these lesions in diagnosis and strategic surgical decisions. PMID:24976137

Ikeda, Osamu; Minami, Norihiko; Yamazaki, Masashi; Koda, Masao; Morinaga, Tatsuo

2015-03-01

130

Hematoma subdural intracraniano pós-anestesia subaracnóidea: relato de dois casos e revisão de 33 casos da literatura Hematoma subdural intracraneal postanestesia subaracnoidea: relato de dos casos y revisión de 33 casos de la literatura Intracranial subdural hematoma post-spinal anesthesia: report of two cases and review of 33 cases in the literature  

OpenAIRE

JUSTIFICATIVA E OBJETIVOS: Hematoma subdural intracraniano é uma complicação rara pós-anestesia subaracnóidea. Relatamos dois casos de mulheres que desenvolveram hematoma subdural crônico pós-anestesia subaracnóidea, diagnosticados após a evolução clínica prolongada de cefaleia pós-punção dural (CPPD) e analisamos outros 33 casos encontrados em revisão da literatura. RELATO DOS CASOS: Nos 35 pacientes (idade entre 20-88 anos, 19 homens), 14 tinham mais de 60 anos (40%) sendo 1...

Jane Auxiliadora Amorim; Diana Souza Canuto dos Anjos Remígio; Otávio Damázio Filho; Marcos Aureliano Guerra de Barros; Valentina Nicole Carvalho; Marcelo Moraes Valença

2010-01-01

131

Acute subdural hematoma from bridging vein rupture: a potential mechanism for growth.  

Science.gov (United States)

Most acute subdural hematomas (ASDHs) develop after rupture of a bridging vein or veins. The anatomy of the bridging vein predisposes to its tearing within the border cell layer of the dura mater. Thus, the subdural hematoma actually forms within the dura. The hematoma grows by continued bleeding into the border cell layer. However, the venous pressure would not be expected to cause a large hematoma. Therefore, some type of mechanism must account for the hematoma's expansion. Cerebral venous pressure (CVP) has been demonstrated in animal models to be slightly higher than intracranial pressure (ICP), and CVP tracks the ICP as pressure variations occur. The elevation of CVP as the ICP increases is thought to result from an increase in outflow resistance of the terminal portion of the bridging veins. This probably results from a Starling resistor model or, less likely, from a muscular sphincter. A hypothesis is derived to explain the mechanism of ASDH enlargement. Tearing of one or more bridging veins causes these vessels to bleed into the dural border cell layer. Subsequent ICP elevation from the ASDH, cerebral swelling, or other cause results in elevation of the CVP by increased outflow resistance in the intact bridging veins. The increased ICP causes further bleeding into the hematoma cavity via the torn bridging veins. Thus, the ASDH enlarges via a positive feedback mechanism. Enlargement of an ASDH would cease as blood within the hematoma cavity coagulates. This would stop the dissection of the dural border cell layer, and pressure within the hematoma cavity would equalize with that in the torn bridging vein or veins. PMID:24313607

Miller, Jimmy D; Nader, Remi

2014-06-01

132

Dural prostate metastasis resembling a chronic subdural haematoma  

OpenAIRE

Subdural hematoma (SDH) is a common neurosurgical pathology, characteristically recognised on plain CT and can be treated with simple and effective surgical intervention. In contrast, dural metastatic adenocarcinoma of the prostate with SDH and malignant extension into the subdural membranes is extremely rare. We describe the case of a 62-year old Caucasian male, provide a brief review of the literature, and explore the potential role of neoangiogenesis and disseminated intravascular coagulop...

O’meara, C.; Mahasneh, T.; Wilson, P.; I’ons, B.; Alkhawaja, D.

2012-01-01

133

Dural prostate metastasis resembling a chronic subdural haematoma.  

Science.gov (United States)

Subdural hematoma (SDH) is a common neurosurgical pathology, characteristically recognised on plain CT and can be treated with simple and effective surgical intervention. In contrast, dural metastatic adenocarcinoma of the prostate with SDH and malignant extension into the subdural membranes is extremely rare. We describe the case of a 62-year old Caucasian male, provide a brief review of the literature, and explore the potential role of neoangiogenesis and disseminated intravascular coagulopathy in SDH development. PMID:24960135

O'Meara, C; Mahasneh, T; Wilson, P; I'Ons, B; Alkhawaja, D

2012-01-01

134

Spontaneous acute subdural hematoma as an initial presentation of choriocarcinoma: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Diverse sequelae of central nervous system metastasis of choriocarcinoma have been reported, including infarction, intra or extra axial hemorrhages, aneurysm formation and carotid-cavernous fistula. Here we report a case of subdural hematoma as the first presentation of choriocarcinoma. Case presentation The patient is a 34-year-old woman whose initial presentation of widely metastatic choriocarcinoma was an acute subdural hematoma, requiring decompressive craniectomy. Histopathologic examination of the tissue showed no evidence of choriocarcinoma, but the patient was found to have diffuse metastatic disease and cerebrospinal fluid indices highly suggestive of intracranial metastasis. Conclusion Choriocarcinoma frequently metastasizes intracranially. We review the diverse possible manifestations of this process. In addition, the cerebrospinal fluid:serum beta-human chorionic gonadotropin ratio is an important factor in diagnosing these cases. Finally, the role of the neurosurgeon is discussed.

Rocque Brandon G

2008-06-01

135

Spontaneous spinal subarachnoid hemorrhage associated with subdural hematoma at different spinal levels  

OpenAIRE

We describe the clinical features and MR-imaging findings of spontaneous spinal subarachnoid hemorrhage located in the lumbar spine associated with subdural hematoma at a higher, thoracic level in a 66-year-old man without neurological deficit. The sequential MR-imaging changes of hemorrhage at various stages in its evolution are portrayed. The possible pathogenetic mechanism for these very unusual, combined hemorrhages in both spinal compartments is discussed.

Kakitsubata, Yousuke; Theodorou, Stavroula J.; Theodorou, Daphne J.; Miyata, Yuko; Ito, Yasunori; Yuki, Yasuhiro; Honbu, Koichi; Maehara, Toyo

2009-01-01

136

Hematoma subdural crônico: estudo de 161 pacientes operados e a relação com alterações no coagulograma  

OpenAIRE

O objetivo deste estudo é analisar a evolução de pacientes com hematoma subdural crônico em relação aos achados do coagulograma. Foram analisados 161 pacientes operados no Hospital das Clínicas-UNICAMP entre abril de 1994 e 2000. Foi detectado um predomínio do sexo masculino (86,3%), da cor branca (85,1%) e da faixa etária na quinta década (mediana 57 anos). O estudo mostrou mortalidade maior no período pós-operatório entre os pacientes com valores de RNI (international normalize...

Yasuda Clarissa Lin; Morita Márcia Elisabete; Nishimori Fernanda Yoshi; Yasuda Agnes Meri; Alves Hélvio Leite

2003-01-01

137

Anesthetic management of a patient with hemophilia A with spontaneous acute subdural hematoma  

OpenAIRE

Intracranial hemorrhage in patients with hemophilia is associated with high mortality and sequelae. We report the case of 50-year-old man with Hemophilia A, who presented with spontaneous acute subdural hematoma and underwent craniotomy for clot evacuation. The patient received Factor VIII infusions perioperatively along with other measures to decrease blood loss. The patient presented with signs of high intracranial tension and received 3% saline intraoperatively and postoperatively to preve...

Gyanesh, Prakhar; Dhiraaj, Sanjay

2013-01-01

138

Acute spontaneous subdural hematoma of arterial origin: A report of four cases and review of literature  

OpenAIRE

Acute spontaneous subdural hematoma of arterial origin, a neurosurgical emergency resulting from rupture of the perisylvian cortical artery, is a rare occurrence. We report four such patients who presented with progressive neurological deterioration. All the patients were operated and perisylvian cortical artery was identified as the source of bleeding in all the patients. Three of the patients had associated hypertension. We reviewed the clinical characteristics, etiology, and outcome of the...

Chhiber Sarbjit; Singh J

2010-01-01

139

Occult falcine meningioma unmasked following nearly complete hemorrhagic transformation with resultant spontaneous acute interhemispheric subdural hematoma.  

Science.gov (United States)

Sudden-onset monoplegia with features of vomiting and headache usually signals an intracranial cerebrovascular event. We describe a 62-year-old man in whom this presentation was the result of the rare occurrence of an almost complete hemorrhagic transformation of a falcine meningioma with resultant acute interhemispheric subdural hematoma, and discuss the risk factors and possible mechanisms that may lead to such an event. The need for careful examination of the available radiology and aggressive tumor removal is stressed. PMID:25552860

Krishnan, Prasad; Jena, Manaranjan; Kartikueyan, Rajaraman

2015-01-01

140

Occult falcine meningioma unmasked following nearly complete hemorrhagic transformation with resultant spontaneous acute interhemispheric subdural hematoma  

OpenAIRE

Sudden-onset monoplegia with features of vomiting and headache usually signals an intracranial cerebrovascular event. We describe a 62-year-old man in whom this presentation was the result of the rare occurrence of an almost complete hemorrhagic transformation of a falcine meningioma with resultant acute interhemispheric subdural hematoma, and discuss the risk factors and possible mechanisms that may lead to such an event. The need for careful examination of the available radiology and aggres...

Krishnan, Prasad; Jena, Manaranjan; Kartikueyan, Rajaraman

2015-01-01

141

Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture  

OpenAIRE

Nissrine Louhab,1 Nawal Adali,1 Mehdi Laghmari,2 Wafae El Hymer,2 Said Ait Ben Ali,2 Najib Kissani11Neurology Department, 2Neurosurgery Department, University Hospital of Mohammed the VIth, Cadi Ayyad University, Marrakech, MoroccoIntroduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF) hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma fol...

Louhab N; Adali N; Laghmari M; El Hymer W; Ait Ben Ali S; Kissani N

2014-01-01

142

Management of Patients Presenting with Acute Subdural Hematoma due to Ruptured Intracranial Aneurysm  

OpenAIRE

Acute subdural hematoma is a rare presentation of ruptured aneurysms. The rarity of the disease makes it difficult to establish reliable clinical guidelines. Many patients present comatose and differential diagnosis is complicated due to aneurysm rupture results in or mimics traumatic brain injury. Fast decision-making is required to treat this life-threatening condition. Determining initial diagnostic studies, as well as making treatment decisions, can be complicated by rapid deterioration o...

Serge Marbacher; Ottavio Tomasi; Javier Fandino

2012-01-01

143

Motor Vehicle Crash-Related Subdural Hematoma from Real-World Head Impact Data  

OpenAIRE

Approximately 1,700,000 people sustain a traumatic brain injury (TBI) each year and motor vehicle crashes (MVCs) are a leading cause of hospitalization from TBI. Acute subdural hematoma (SDH) is a common intracranial injury that occurs in MVCs associated with high mortality and morbidity rates. In this study, SDH volume and midline shift have been analyzed in order to better understand occupant injury by correlating them to crash and occupant parameters. Fifty-seven head computed tomography (...

Urban, Jillian E.; Whitlow, Christopher T.; Edgerton, Colston A.; Powers, Alexander K.; Maldjian, Joseph A.; Stitzel, Joel D.

2012-01-01

144

Acute intracranial hematoma formation following excision of a cervical subdural tumor: a report of two cases and literature review.  

Science.gov (United States)

An intracranial hematoma is a rare, yet significant, complication following spinal surgery. The authors describe two cases with acute intracranial hematoma formation after excision of a cervical subdural schwannoma. One was a 14-year-old girl who developed bilateral intracranial extradural hematomas immediately following excision of the C4 subdural schwannoma. The other was a 59-year-old woman who had an acute cerebellar hematoma after removal of the C2-C5 subdural schwannoma. During the surgeries of both cases, spinal dura was partially removed together with the tumor and the dural sac could not be repaired, resulting in large amounts of intraoperative CSF loss and persistent postoperative CSF leakage. Both patients failed to regain consciousness from anesthesia after surgery, and a cranial CT scan identified large intracranial hematomas. Urgent hematoma evacuation was ultimately performed to save the patients. Based on the authors' experience and literature review, a conclusion was drawn that considerable CSF leakage and a sharp decrease of CSF pressure are common features during the excision of a spinal subdural tumor, which may lead to acute intracranial hematomas. Continual postoperative monitoring in patients with this condition should be of a very high priority. A CT or MRI should be immediately investigated to exclude intracranial hematomas for any patient with delayed emergence from anesthesia following spinal surgery. Hematoma evacuation is indispensable once an intracranial hematoma is identified in the patient who fails to regain consciousness from anesthesia post surgery. Furthermore, the possible pathophysiological mechanisms responsible for the formation of an intracranial hematoma after spinal procedures, particularly after manipulations of a cervical subdural tumor, are discussed. PMID:23848602

Ma, Xuexiao; Zhang, Yan; Wang, Ting; Li, Guizhi; Zhang, Guoqing; Khan, Hassan; Xiang, Hongfei; Chen, Bohua

2014-01-01

145

Concurrent intracranial and spinal subdural hematoma in a teenage athlete: a case report of this rare entity.  

Science.gov (United States)

A 15-year-old male high school football player presented with episodes of headache and complete body stiffness, especially in the arms, lower back, and thighs, immediately following a football game. This was accompanied by severe nausea and vomiting for several days. Viral meningitis was suspected by the primary clinician, and treatment with corticosteroids was initiated. Over the next several weeks, there was gradual symptom improvement and the patient returned to his baseline clinical status. The patient experienced a severe recurrence of the previous myriad of symptoms following a subsequent football game, without an obvious isolated traumatic episode. In addition, he experienced a new left sided headache, fatigue, and difficulty ambulating. He was admitted and an extensive workup was performed. CT and MRI of the head revealed concurrent intracranial and spinal subdural hematomas (SDH). Clinical workup did not reveal any evidence of coagulopathy or predisposing vascular lesions. Spinal SDH is an uncommon condition whose concurrence with intracranial SDH is an even greater clinical rarity. We suggest that our case represents an acute on chronic intracranial SDH with rebleeding, membrane rupture, and symptomatic redistribution of hematoma to the spinal subdural space. PMID:25349764

Treister, Daniel S; Kingston, Sara E; Zada, Gabriel; Singh, Manu; Jones, Jesse G A; Mills, Jena N; Lerner, Alexander; Boyko, Orest B; Law, Meng; Rajamohan, Anandh; Shiroishi, Mark S

2014-01-01

146

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports  

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Full Text Available Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature. Case presentation We report two cases of people (a 23-year-old man and a 41-year-old man with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma. Conclusion It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.

Pillai Promod

2009-02-01

147

Outcome of burr hole surgery in the emergency room for severe acute subdural hematoma  

International Nuclear Information System (INIS)

We have performed burr hole surgery in the emergency room for severe acute subdural hematoma from April 2007 in twenty five patients. All patients were deep comatose and showed cerebral herniation sign with bilateral pupillary abnormalities. Burr hole surgeries were performed as soon as possible after CT evaluation. Continually decomporresive craiectomies were followed if clinical improvements were achieved and mild baribiturate-moderate hypothermia combined (MB-MH) therapy was induced postoperatively in some cases. The mean average was 65.6 years (range 16-93). The causes of head injuries were traffic accident in 9, fall down in 13 and unknown in 3. The mean Glasgow coma scale (GCS) on admission was 4.4 (range 3-9). The mean time interval from arrival to burr hole surgery was 33.5 minutes (range 21-50 minutes). Decompressive craniectomy was indicated in 14 cases and MB-MH therapy was induced in 13 cases. The overall clinical outcome consisted of good recovery in 3, moderate disability in 2, severe disability in 3, persistent vegetative state in 3 and death in 14. Favorable results can be expected even in patients with serious acute subdural hematoma. Emergent burr hole surgery was effective to decrease intracranial pressure rapidly and to save time. So active burr hole surgery in the emergency room is strongly recommended to all cases of severe acute subdural hematoma. (author)

148

Hematoma subdural de medula espinhal associada ao uso de anticoagulante oral / Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA) / Hematoma subdural de la médula espinal asociado al uso de anticoagulante oral  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese, Spanish Abstract in portuguese O hematoma subdural de medula espinhal (HSDME) é uma complicação rara decorrente do uso de antagonistas de vitamina K (AVK) e de diagnostico difícil. Este artigo apresenta um caso com complicação ameaçadora à vida: um paciente octogenário portador de fibrilação atrial de início recente em uso de AVK [...] . A história e o exame físico inicialmente se apresentavam normais, associados com a elevação dos valores de coagulograma supraterapêuticos (INR > 10). Após 24 horas da admissão hospitalar, o paciente apresentou tetraparesia progressiva, evidenciando na ressonância nuclear magnética (RNM) de medula espinhal um HSDME (Figura 1). Após reversão completa da hipocoagulação e intervenção neurocirúrgica o paciente obteve melhora do quadro neurológico. Abstract in spanish El hematoma subdural espinal (HSE) es una complicación rara proveniente del uso de antagonistas de vitamina K (AVK) y de diagnostico difícil. Este artículo presenta un caso con complicación amenazadora para la vida: un paciente octogenario portador de fibrilación auricular de inicio reciente, en uso [...] de AVK. Inicialmente, la historia y el examen físico se presentaban normales, asociados a la elevación de los valores de coagulograma supra terapéuticos (INR > 10). Tras 24 horas del ingreso hospitalario, el paciente presentó tetraparesia progresiva. Al realizarse una resonancia nuclear magnética (RNM) de médula espinal, se evidenció un HSE (Figura 1). Tras reversión completa de la hipocoagulación e intervención neuroquirúrgica el paciente obtuvo mejora del cuadro neurológico. Abstract in english Spinal subdural hematoma (SSDH) is a rare condition, which is difficult to diagnose, related to Vitamin K Antagonist. This a case report of a life-threatening situation in a octogenarian patient with a history of recent atrial fibrillation that received K-Vitamin Antagonist (KVA) therapy. The histor [...] y and the clinical assessment were normal at the admission, associated with increase in the coagulation parameters (INR >10). Twenty-four hours after the admission, the patient developed progressive tetraparesis and a Magnetic Resonance Imaging (MRI) was performed, disclosing the evidence of a SSDH (Figure 1). An emergency neurosurgical intervention was performed associated with normalization of the coagulation parameters. After the procedure, the patient presented improvement of the neurological symptoms.

Uri Adrian Prync, Flato; Paulo Sérgio, Rheder; Helio Penna, Guimarães; Elias Silva, Flato; Paulo, Cretella.

2009-01-01

149

Hematoma subdural de medula espinhal associada ao uso de anticoagulante oral Hematoma subdural de la médula espinal asociado al uso de anticoagulante oral Spine subdural hematoma: a rare complication associated with vitamin K antagonist (VKA  

Directory of Open Access Journals (Sweden)

Full Text Available O hematoma subdural de medula espinhal (HSDME é uma complicação rara decorrente do uso de antagonistas de vitamina K (AVK e de diagnostico difícil. Este artigo apresenta um caso com complicação ameaçadora à vida: um paciente octogenário portador de fibrilação atrial de início recente em uso de AVK. A história e o exame físico inicialmente se apresentavam normais, associados com a elevação dos valores de coagulograma supraterapêuticos (INR > 10. Após 24 horas da admissão hospitalar, o paciente apresentou tetraparesia progressiva, evidenciando na ressonância nuclear magnética (RNM de medula espinhal um HSDME (Figura 1. Após reversão completa da hipocoagulação e intervenção neurocirúrgica o paciente obteve melhora do quadro neurológico.El hematoma subdural espinal (HSE es una complicación rara proveniente del uso de antagonistas de vitamina K (AVK y de diagnostico difícil. Este artículo presenta un caso con complicación amenazadora para la vida: un paciente octogenario portador de fibrilación auricular de inicio reciente, en uso de AVK. Inicialmente, la historia y el examen físico se presentaban normales, asociados a la elevación de los valores de coagulograma supra terapéuticos (INR > 10. Tras 24 horas del ingreso hospitalario, el paciente presentó tetraparesia progresiva. Al realizarse una resonancia nuclear magnética (RNM de médula espinal, se evidenció un HSE (Figura 1. Tras reversión completa de la hipocoagulación e intervención neuroquirúrgica el paciente obtuvo mejora del cuadro neurológico.Spinal subdural hematoma (SSDH is a rare condition, which is difficult to diagnose, related to Vitamin K Antagonist. This a case report of a life-threatening situation in a octogenarian patient with a history of recent atrial fibrillation that received K-Vitamin Antagonist (KVA therapy. The history and the clinical assessment were normal at the admission, associated with increase in the coagulation parameters (INR >10. Twenty-four hours after the admission, the patient developed progressive tetraparesis and a Magnetic Resonance Imaging (MRI was performed, disclosing the evidence of a SSDH (Figure 1. An emergency neurosurgical intervention was performed associated with normalization of the coagulation parameters. After the procedure, the patient presented improvement of the neurological symptoms.

Uri Adrian Prync Flato

2009-01-01

150

Safe implementation of mechanical thrombectomy in acute stroke patients with major arterial occlusion and concomitant subdural hematoma.  

Science.gov (United States)

Mechanical thrombectomy (MT) alone in cases of large-vessel acute ischemic stroke (AIS) with a concomitant subdural hematoma (SDH) seems feasible and safe, but there's still a lack of evidence in the clinical literature. We report three cases of AIS with SDH, of which MT was performed with successful recanalization and no major changes in SDH: two elderly men with acute traumatic SDH and one man with incidental chronic SDH. (1) A 67-year-old man with acute traumatic SDH in the right side developed right middle cerebral artery (MCA) stroke, (2) a 72-year-old man with chronic SDH in the left side developed right MCA stroke, and (3) a 76-year-old-man with acute traumatic SDH in the right side developed top-of-basilar artery syndrome. As for AIS patients with a SDH, MT may be the only feasible and safe treatment option. PMID:24024077

Kim, Yong-Won; Kang, Dong-Hun; Hwang, Yang-Ha; Kim, Yong-Sun; Park, Sung-Pa

2013-09-01

151

Acute Interhemispheric Subdural Hematomas: A Report of 3 Cases and Review of the Literature  

Directory of Open Access Journals (Sweden)

Full Text Available The development of acute supratentorial interhemispheric subdural hematomas is an uncommon yet a highly distinct event because of their unusual location, unknown natural history, and debated management. The majority develop in patients with head trauma, generalized bleeding tendency, or coagulopathy. We report on 3 patients who developed spontaneous acute inter-hemispheric subdural hematomas. They were 72, 66, and 65 years old, respectively. Two were males and the 3rd was a female. There was no head trauma, bleeding tendency, or coagulopathy. Two of them were hypertensive but none of them was diabetic, epileptic, or alcoholic. Two patients died, on day 1 and 2 respectively, and the 3rd patient was discharged by his next of kin after 3 hours of admission to our Acute and Emergency department. No neurosurgical intervention was carries out and all patients were treated conservatively. The hematoma was fronto-occipital and was located on the left side in 2 patients while in the 3rd patient it was a right-sided parieto-occipital one. Although the initial investigations had pointed out to the spontaneous development of those hematomas in our patients, a further search for an underlying etiology was supposed to be done, but the early death of 2 patients and the premature discharge of the 3rd patient had intersected with this work-up. The rapid deterioration and death of 2 patients might have been prevented if an early evacuation was done.

Osama Shukir Muhammed Amin

2014-02-01

152

A case of acute traumatic subdural hematoma in a child with previous bilateral encephaloduroarteriosynangiosis.  

Science.gov (United States)

The authors report the case of a 5-year-old female with right-sided hemiparesis and aphasia secondary to moyamoya disease, who had previously undergone staged bilateral encephaloduroarteriosynangiosis procedures. A subsequent ground-level fall caused an acute traumatic subdural hematoma with mass effect and neurological decline. She underwent emergency hematoma evacuation and decompressive craniectomy, which required interruption of the superficial temporal artery that had been used for indirect bypass, followed later by autologous cranioplasty. There were no acute or long-term ischemic events related to the occurrence or treatment of the traumatic hematoma. Follow-up angiography revealed extensive spontaneous vascular collateralization in the field of the decompressive craniectomy and cranioplasty. The patient returned to her pre-injury neurological baseline. PMID:24081710

Curry, Merlin; Whitney, Nathaniel; Roundy, Neil; Selden, Nathan R

2014-04-01

153

Rapid resolution of an acute subdural hematoma by increasing the shunt valve pressure in a 63-year-old man with normal-pressure hydrocephalus with a ventriculoperitoneal shunt: a case report and literature review  

OpenAIRE

Abstract Introduction Symptomatic subdural hematoma development is a constant concern for patients who have undergone cerebrospinal fluid shunting procedures to relieve symptoms related to normal-pressure hydrocephalus. Acute subdural hematomas are of particular concern in these patients as even minor head trauma may result in subdural hematoma formation. The presence of a ventricular shunt facilitates further expansion of the subdural hematoma and often necessitates surgical treatment, inclu...

Hayes Jackson; Roguski Marie; Riesenburger Ron I

2012-01-01

154

Time interval to surgery and outcomes following the surgical treatment of acute traumatic subdural hematoma.  

Science.gov (United States)

Although the pre-surgical management of patients with acute traumatic subdural hematoma prioritizes rapid transport to the operating room, there is conflicting evidence regarding the importance of time interval from injury to surgery with regards to outcomes. We sought to determine the association of surgical timing with outcomes for subdural hematoma. A retrospective review was performed of 522 consecutive patients admitted to a single center from 2006-2012 who underwent emergent craniectomy for acute subdural hematoma. After excluding patients with unknown time of injury, penetrating trauma, concurrent cerebrovascular injury, epidural hematoma, or intraparenchymal hemorrhage greater than 30 mL, there remained 45 patients identified for analysis. Using a multiple regression model, we examined the effect of surgical timing, in addition to other variables on in-hospital mortality (primary outcome), as well as the need for tracheostomy or gastrostomy (secondary outcome). We found that increasing injury severity score (odds ratio [OR] 1.146; 95% confidence interval [CI] 1.035-1.270; p=0.009) and age (OR1.066; 95%CI 1.006-1.129; p=0.031) were associated with in-hospital mortality in multivariate analysis. In this model, increasing time to surgery was not associated with mortality, and in fact had a significant effect in decreasing mortality (OR 0.984; 95%CI 0.971-0.997; p=0.018). Premorbid aspirin use was associated with a paradoxical decrease in mortality (OR 0.019; 95%CI 0.001-0.392; p=0.010). In this patient sample, shorter time interval from injury to surgery was not associated with better outcomes. While there are potential confounding factors, these findings support the evaluation of rigorous preoperative resuscitation as a priority in future study. PMID:25065950

Walcott, Brian P; Khanna, Arjun; Kwon, Churl-Su; Phillips, H Westley; Nahed, Brian V; Coumans, Jean-Valery

2014-12-01

155

Erythropoietin neuroprotection is enhanced by direct cortical application following subdural blood evacuation in a rat model of acute subdural hematoma.  

Science.gov (United States)

Recombinant human erythropoietin (EPO) has been successfully tested as neuroprotectant in brain injury models. The first large clinical trial with stroke patients, however, revealed negative results. Reasons are manifold and may include side-effects such as thrombotic complications or interactions with other medication, EPO concentration, penetration of the blood-brain-barrier and/or route of application. The latter is restricted to systemic application. Here we hypothesize that EPO is neuroprotective in a rat model of acute subdural hemorrhage (ASDH) and that direct cortical application is a feasible route of application in this injury type. The subdural hematoma was surgically evacuated and EPO was applied directly onto the surface of the brain. We injected NaCl, 200, 2000 or 20,000IU EPO per rat i.v. at 15min post-ASDH (400?l autologous venous blood) or NaCl, 0.02, 0.2 or 2IU per rat onto the cortical surface after removal of the subdurally infused blood t at 70min post-ASDH. Arterial blood pressure (MAP), blood chemistry, intracranial pressure (ICP), cerebral blood flow (CBF) and brain tissue oxygen (ptiO2) were assessed during the first hour and lesion volume at 2days after ASDH. EPO 20,000IU/rat (i.v.) elevated ICP significantly. EPO at 200 and 2000IU reduced lesion volume from 38.2±0.6mm(3) (NaCl-treated group) to 28.5±0.9 and 22.2±1.3mm(3) (all psubdural blood removal. High systemic and topically applied concentrations caused adverse effects on lesion size which were partially due to increased ICP. Thus, patients with traumatic ASDH could be treated with cortically applied EPO but with caution concerning concentration. PMID:23415790

Rahimi Nedjat, M; Wähmann, M; Bächli, H; Güresir, E; Vatter, H; Raabe, A; Heimann, A; Kempski, O; Alessandri, B

2013-05-15

156

Hematoma subdural agudo espontâneo e hemorragia intracerebral em paciente com microangiopatia trombótica gestacional / Spontaneous acute subdural hematoma and intracerebral hemorrhage in a patient with thrombotic microangiopathy during pregnancy  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese Pré-eclâmpsia, síndrome HELLP (hemólise, elevação de enzimas hepáticas e plaquetopenia) e fígado gorduroso agudo da gestação são as principais causas de microangiopatia trombótica e disfunção hepática grave durante a gestação, representando um spectrum do mesmo processo patológico. Relatou-se aqui o [...] caso de uma gestante com 35 semanas internada em unidade de terapia intensiva no pós-operatório imediato de cesariana por morte fetal, com náuseas, vômitos e icterícia. Diagnosticaram-se pré-eclâmpsia pós-parto e fígado gorduroso agudo da gestação. Houve evolução tardia com hematoma subdural agudo e hemorragia intracerebral, sendo realizado tratamento neurocirúrgico. A paciente foi a óbito por anemia hemolítica refratária, com sangramento espontâneo em múltiplos órgãos. Pré-eclâmpsia, síndrome HELLP e fígado gorduroso agudo da gestação são processos patológicos que podem se sobrepor e se associar a complicações potencialmente fatais, como a hemorragia intracraniana aqui descrita. Sua detecção e diagnóstico precoces são fundamentais para a instituição de manejo adequado e sucesso do tratamento. Abstract in english Preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low-platelet count), and acute fatty liver of pregnancy are the main causes of thrombotic microangiopathy and evere liver dysfunction during pregnancy and represent different manifestations of the same pathological continuum. The c [...] ase of a 35-week pregnant woman who was admitted to an intensive care unit immediately after a Cesarean section due to fetal death and the presence of nausea, vomiting, and jaundice is reported. Postpartum preeclampsia and acute fatty liver of pregnancy were diagnosed. The patient developed an acute subdural hematoma and an intracerebral hemorrhage, which were subjected to neurosurgical treatment. The patient died from refractory hemolytic anemia and spontaneous bleeding of multiple organs. Preeclampsia HELLP syndrome, and acute fatty liver of pregnancy might overlap and be associated with potentially fatal complications, including intracranial hemorrhage, as in the present case. Early detection and diagnosis are crucial to ensure management and treatment success.

Sâmia Yasin, Wayhs; Joise, Wottrich; Douglas Prestes, Uggeri; Fernando Suparregui, Dias.

2013-06-01

157

Successful subthalamic nucleus deep brain stimulation therapy after significant lead displacement from a subdural hematoma.  

Science.gov (United States)

A 57-year-old man with a 21 year history of Parkinson's disease underwent bilateral subthalamic nucleus deep brain stimulation (DBS) placement. One week postoperatively he developed an acute left subdural hematoma from a fall with significant displacement of the DBS leads. It was promptly evacuated, the patient slowly recovered neurologically, and the leads again moved near to the original position. Six months of stimulation therapy attained 50% reduction in symptoms. This case report demonstrates the movement of DBS leads due to brain shift and their ability to come back to previous location once the brain shift is corrected. PMID:25304438

Henderson, Esmiralda Yeremeyeva; Goble, Timothy; D'Haese, Pierre-François; Pallavaram, Srivatsan; Oluigbo, Chima; Agrawal, Punit; Deogaonkar, Milind; Rezai, Ali

2015-02-01

158

Recombinant factor Vlla therapy in a patient on long term anticoagulant treatment with a bleeding and acute subdural hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available In this paper we report on the successful correction of a coagulopathy with activated recombinant factor seven (rFVIIa therapy which enabled surgical removal of a life threatening subdural hematoma. The severe coagulopathy developed due to long term warfarin therapy, which followed heart valvular reconstruction and replacement. The coagulopathy failed to improve following fresh frozen plasma and vitamin K therapy. Activated recombinant factor VII therapy became the treatment of choice, which enabled the life saving surgical removal of the subdural hematoma.

Mladen Novkoski

2007-10-01

159

Tension pneumocephalus following evacuation of chronic subdural haematoma.  

Science.gov (United States)

Five cases of a rare complication of tension pneumocephalus following evacuation of chronic subdural haematoma are described. This occurred in 8% of all cases of chronic subdural haematoma treated following installation of a CT scanner. The chronically compressed brain contributes to the ingress of this intracranial air. The increase in the brain bulk and gradual re-expansion of the brain, in the early postoperative period, competes with the trapped subdural air resulting in a rise in intracranial pressure leading to neurological deterioration. Twist drill craniostomy and aspiration, using a brain cannula with a three-way connector, has produced excellent results. PMID:2789723

Sharma, B S; Tewari, M K; Khosla, V K; Pathak, A; Kak, V K

1989-01-01

160

Spinal subdural hematoma following lumbar decompressive surgery: a report of two cases.  

Science.gov (United States)

Spinal subdural hematoma (SSDH) following spine surgery is an extremely rare condition, with only three cases being reported in the literature. Unintended durotomy has been associated with SSDH due to alterations of pressures in the dural compartments. The objective of the present report was to report two rare cases of acute SSDH developed after lumbar decompressive surgery. In one of the patients, the diagnosis of SSDH was followed by urgent hematoma evacuation via durotomy due to the patient's worsening neurological symptoms. In the second patient, the SSDH was treated conservatively due to the absence of severe or progressive motor or sensory deficits. In conclusion, emergency evacuation via durotomy is the treatment of choice for patients with SSDH and neurologic impairment. Conservative management may be indicated in selected cases with absent motor and sensory deficits. PMID:25398290

Lykissas, Marios G; Aichmair, Alexander; Herzog, Richard J; Schroeder, Joshua E; Huang, Russel C; Farmer, James

2015-01-01

161

Fatal deterioration of delayed acute subdural hematoma after mild traumatic brain injury: two cases with brief review.  

Science.gov (United States)

Both delayed posttraumatic intracerebral hemorrhage and epidural hematoma have been well described in the neurosurgical literatures. However, delayed posttraumatic acute subdural hematoma which happens more than a week with a rapid progress after mild traumatic brain injury and causes death of patient is rarely reported. We show two such cases and briefly review the literature and discuss the probable pathogenesis of their rapid progress. PMID:24698583

Chen, Shiwen; Xu, Chen; Yuan, Lutao; Tian, Hengli; Cao, Heli; Guo, Yan

2014-04-01

162

Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage and Shaken Baby Syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Child abuse experts use diagnostic findings of subdural hematoma and retinal hemorrhages as near-pathognomonic findings to diagnose shaken baby syndrome. This article reviews the origin of this link and casts serious doubt on the specificity of the pathophysiologic connection. The forces required to cause brain injury were derived from an experiment of high velocity impacts on monkeys, that generated forces far above those which might occur with a shaking mechanism. These forces, if present, would invariably cause neck trauma, which is conspicuously absent in most babies allegedly injured by shaking. Subdural hematoma may also be the result of common birth trauma, complicated by prenatal vitamin D deficiency, which also contributes to the appearance of long bone fractures commonly associated with child abuse. Retinal hemorrhage is a non-specific finding that occurs with many causes of increased intracranial pressure, including infection and hypoxic brain injury. The evidence challenging these connections should prompt emergency physicians and others who care for children to consider a broad differential diagnosis before settling on occult shaking as the de-facto cause. While childhood non-accidental trauma is certainly a serious problem, the wide exposure of this information may have the potential to exonerate some innocent care-givers who have been convicted, or may be accused, of child abuse. [West J Emerg Med. 2011;12(2:144-158.

Gabaeff, Steven C

2011-05-01

163

Misdiagnosed spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture  

Directory of Open Access Journals (Sweden)

Full Text Available Nissrine Louhab,1 Nawal Adali,1 Mehdi Laghmari,2 Wafae El Hymer,2 Said Ait Ben Ali,2 Najib Kissani11Neurology Department, 2Neurosurgery Department, University Hospital of Mohammed the VIth, Cadi Ayyad University, Marrakech, MoroccoIntroduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture.Observation: A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence.Conclusion: Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures.Keywords: intracranial hypotension, headache, magnetic resonance imaging

Louhab N

2014-01-01

164

Surgical management of traumatic acute subdural hematoma in adults: a review.  

Science.gov (United States)

Traumatic acute subdural hematoma (ASDH) is a major clinical entity in traumatic brain injury (TBI). It acts as a space occupying lesion to increase intracranial pressure, and is often complicated by co-existing lesions, and is modified by cerebral blood flow (CBF) changes, coagulopathy, and delayed hematomas. Because of its complicated pathophysiology, the mortality of ASDH is still remaining high. In this review article, its epidemiology, pathophyiology, surgical treatment, and salvage ability are described. With regard to epidemiology, as the population ages, growing number of elderly patients with ASDH, especially patients with prehospital anticoagulant and antiplatelets, increase. Concerning pathophysiology, in addition to well-known initial intracranial hypertension and subsequent ischemia, delayed hyperemia/hyperperfusion, or delayed hematoma is being recognized frequently in recent years. However, optimal treatments for these delayed phenomenons have not been established yet. With regard to surgical procedures, all of craniotomy, decompressive craniectomy, and initial trephination strategies seem to be effective, but superiority of each procedure have not been established yet. Since Glasgow Coma Scale (GCS) scores, age, papillary reaction, and computed tomographic findings are strongly correlated to outcome, each factor has been investigated as an indicator of salvage ability. None of them, however, has been defined as such one. In future studies, epidemiological changes as population ages, management of delayed pathophysiology, superiority of each surgical procedures, and salvage ability should be addressed. PMID:25367584

Karibe, Hiroshi; Hayashi, Toshiaki; Hirano, Takayuki; Kameyama, Motonobu; Nakagawa, Atsuhiro; Tominaga, Teiji

2014-01-01

165

Acute spontaneous subdural hematoma of arterial origin: A report of four cases and review of literature  

Directory of Open Access Journals (Sweden)

Full Text Available Acute spontaneous subdural hematoma of arterial origin, a neurosurgical emergency resulting from rupture of the perisylvian cortical artery, is a rare occurrence. We report four such patients who presented with progressive neurological deterioration. All the patients were operated and perisylvian cortical artery was identified as the source of bleeding in all the patients. Three of the patients had associated hypertension. We reviewed the clinical characteristics, etiology, and outcome of the reported cases in the literature. A high index of suspicion is necessary even in young patients in view of the phenomenon of re-rupture mimicking stroke. Early diagnosis and a wide craniotomy over the sylvian fissure to obtain hemostasis of bleeding points results in good outcome.

Chhiber Sarbjit

2010-01-01

166

Factors associated with hemispheric hypodensity after subdural hematoma following abusive head trauma in children.  

Science.gov (United States)

Abusive head trauma (AHT) is a unique form of pediatric TBI with increased mortality and neurologic sequelae. Hemispheric hypodensity (HH) in association with subdural blood after AHT has been described. Though risk factors for HH are not understood, we hypothesized that risk factors could be identified. We retrospectively enrolled children under 5 years with TBI secondary to AHT (child advocacy diagnosis) who had undergone initial and interval brain imaging. Records were interrogated for prearrival and in-hospital physiologic and radiographic findings. HH was determined by a blinded observer. Twenty-four children were enrolled and 13 developed HH. HH was not significantly associated with age, initial Glascow Coma Scale, or mortality. Pediatric Intensity Level of Therapy (PILOT) scores (p=0.01) and daily maximal intracranial pressure (ICPmax; p=0.037) were higher in HH. Hypoxia, hypotension, cardiopulmonary arrest, need for blood transfusion, and daily blood glucoses tended to be greater in HH. Whereas all children with HH had acute subdural hematoma (SBH), many children without HH also had subdural blood; the presence of skull fracture was more likely in the children who did not develop HH (p=0.04), but no other intracranial radiographic pattern of injury was associated with HH. Surgical intervention did not appear to protect against development of HH. A variety of insults associated with ischemia, including intracranial hypertension, ICP-directed therapies, hypoxia, hypotension, and cardiac arrest, occurred in the children who developed HH. Given the morbidity and mortality of this condition, larger studies to identify mechanisms leading to the development of HH and mitigating clinical approaches are warranted. PMID:24693985

Foster, Kimberly A; Recker, Matthew J; Lee, Philip S; Bell, Michael J; Tyler-Kabara, Elizabeth C

2014-10-01

167

Comparison Between Cerebral Tissue Oxygen Tension and Energy Metabolism in Experimental Subdural Hematoma  

DEFF Research Database (Denmark)

BACKGROUND: An experimental swine model (n = 7) simulating an acute subdural hematoma (ASDH) was employed (1) to explore the relation between the brain tissue oxygenation (PbtO(2)) and the regional cerebral energy metabolism as obtained by microdialysis, and (2) to define the lowest level of PbtO(2) compatible with intact energy metabolism. METHODS: ASDH was produced by infusion of 7 ml of autologous blood (infusion rate 0.5 ml/min) by a catheter placed subdurally. PbtO(2) and microdialysis probes were placed symmetrically in the injured ("bad-side") and non-injured ("good-side") hemispheres. Intracranial pressure (ICP) was monitored in the "good-side." RESULTS: ICP, cerebral perfusion pressure (CPP), PbtO(2), glucose, lactate, pyruvate, lactate-pyruvate ratio (LP ratio), glutamate, and glycerol were recorded at baseline (60 min) and post trauma (360 min). After the creation of the ASDH, PbtO(2) decreased significantly in both the hemispheres (P 

Nielsen, Troels Halfeld; Engell, Susanne I

2011-01-01

168

CT manifestation of diffuse brain injury in cases of serious acute subdural hematoma  

Energy Technology Data Exchange (ETDEWEB)

Eighty-two adult cases of serious acute subdural hematoma (SDH) of Glasgow Coma Scale 9 or more severe (50 operated-on and 32 non-operated-on cases) were selected in order to study the relation between CT findings at the acute stage and the prognosis of SDH. The CT findings were analyzed in the following respects: size of SDH, midline shift, manifestation of perimesencephalic cisterns, and presence or absence of diffuse hemispheric swelling, diffuse cerebral swelling, subarachnoid hemorrhage, intraventricular hemorrhage, epidural hematoma, hemorrhagic contusion, and dilatation of the contralateral temporal horn. As a result, the most important prognostic signs were found to be: (1) diffuse hemispheric swelling, (2) diffuse cerebral swelling, (3) subarachnoid hemorrhage of the basal-cistern type, (4) intraventricular hemorrhage, (5) deep-seated contusion, (6) complete effacement of the perimesencephalic cisterns, and (7) dilatation of the contralateral temporal horn. These findings, except for the last item, which indicates the final phase of tentorial herniation, were regarded as various patterns of the CT manifestation of diffuse brain injury; the positively associated diffuse brain injury seemed to determine the prognosis of SDH.

Nikaido, Yuji; Shimomura, Takahide; Fujita, Toyohisa; Hirabayashi, Hidehiro; Utsumi, Shozaburo

1987-04-01

169

The CT manifestation of diffuse brain injury in cases of serious acute subdural hematoma  

International Nuclear Information System (INIS)

Eighty-two adult cases of serious acute subdural hematoma (SDH) of Glasgow Coma Scale 9 or more severe (50 operated-on and 32 non-operated-on cases) were selected in order to study the relation between CT findings at the acute stage and the prognosis of SDH. The CT findings were analyzed in the following respects: size of SDH, midline shift, manifestation of perimesencephalic cisterns, and presence or absence of diffuse hemispheric swelling, diffuse cerebral swelling, subarachnoid hemorrhage, intraventricular hemorrhage, epidural hematoma, hemorrhagic contusion, and dilatation of the contralateral temporal horn. As a result, the most important prognostic signs were found to be: (1) diffuse hemispheric swelling, (2) diffuse cerebral swelling, (3) subarachnoid hemorrhage of the basal-cistern type, (4) intraventricular hemorrhage, (5) deep-seated contusion, (6) complete effacement of the perimesencephalic cisterns, and (7) dilatation of the contralateral temporal horn. These findings, except for the last item, which indicates the final phase of tentorial herniation, were regarded as various patterns of the CT manifestation of diffuse brain injury; the positively associated diffuse brain injury seemed to determine the prognosis of SDH. (author)

170

Analysis of 469 cases of acute subdural hematoma. The characteristics of ''talk and deteriorate''patients  

International Nuclear Information System (INIS)

The acute subdural hematoma (ASDH) remains one of the most life-threatening state of all head injuries. We have retrospectively reviewed 469 patients suffering ASDH between 1990 and 2010. The overall mortality rate was 34.1% and 38.6% had good recovery (GR) of Glasgow outcome scale at discharge. The outcome was found to be influenced significantly by the consciousness level at admission. In 198 patients, surgical procedure was performed. Based on the distribution of ASDH, the patients with ASDH only in the interhemispheric space were prone to reach GR state compared to the other locations, namely, unilateral and bilateral lesions. In 469 patients, 28 patients (6%) presented with a mild head injury (JCS 0-3) at admission, and then rapidly deteriorated to comatose state in the first 3 hours, they were classified as ''talk and deteriorate'' (T and D) type. The mortality rate of T and D type was 61%, and the outcome of T and D type was significantly correlated with the operative procedures such as removal via one-burr hole, removal via craniotomy, and decompressive craniotomy and removal. The more degree of decompression, the better outcome is expected for the T and D type. But the independent predictable signs in initial CT scan for T and D type, such as the combination of contusion and/or acute epidural hematoma, in order to evacuate the hematoma promptly before the deterioration falls to the critical level, failed to be identified. Therefore, we conclude that patients ied. Therefore, we conclude that patients who present in good clinical condition with ASDH initially must be prepared for emergency operation. (author)

171

Automated detection of extradural and subdural hematoma for contrast-enhanced CT images in emergency medical care  

Science.gov (United States)

We have been developing the CAD scheme for head and abdominal injuries for emergency medical care. In this work, we have developed an automated method to detect typical head injuries, rupture or strokes of brain. Extradural and subdural hematoma region were detected by comparing technique after the brain areas were registered using warping. We employ 5 normal and 15 stroke cases to estimate the performance after creating the brain model with 50 normal cases. Some of the hematoma regions were detected correctly in all of the stroke cases with no false positive findings on normal cases.

Hara, Takeshi; Matoba, Naoto; Zhou, Xiangrong; Yokoi, Shinya; Aizawa, Hiroaki; Fujita, Hiroshi; Sakashita, Keiji; Matsuoka, Tetsuya

2007-03-01

172

Hematoma epidural lumbar crónico espontáneo / Chronic spontaneous lumbar epidural hematoma  

Scientific Electronic Library Online (English)

Full Text Available Presentamos un caso excepcional de estenosis de canal lumbar con síndrome de cola de caballo por un hematoma crónico espontáneo en el espacio epidural L2-L3. Se trata de un varón de 53 años que, sin ninguna clase de antecedente patológico relacionado con el problema actual (traumatismos, punciones l [...] umbares, toma de antiagregantes o anticoagulantes), presenta una colección hemática epidural que va comprimiendo progresivamente la cola de caballo. Las pruebas de imagen mostraron una colección polilobulada, bien delimitada, que se interpretó como quiste sinovial. Tras la cirugía (laminectomía descompresiva y evacuación) se confirmó el diagnóstico con estudio histológico. Tras la operación se recuperó por completo la función neurológica. Abstract in english We report an exceptional case of cauda equina syndrome, caused by a chronic epidural hematoma of the lumbar spine, (L2-L3). A 53 year old man without history of trauma, lumbar punctures or antiagregant medication, suffered from progressive back pain and minor motor deficit in the legs. The etiology, [...] MRI, intraoperative findings and microscopical study are presented and discussed. After surgery there was a complete resolution of the clinical picture.

J.M., Belinchón; J., Campos; J., Merino; J.M., Gallego; C., Barcia.

2005-12-01

173

Acute infratentorial traumatic subdural hematoma associated with a torn tentorium cerebelli in a one-year-old boy  

International Nuclear Information System (INIS)

The case of a 1-year-old boy with an acute infratentorial subdural hematoma is presented. Surgical intervention revealed a bleeding vein at the edge of a right-sided tentorial tear. Traumatic tentorial tearing has been demonstrated previously only in neonates. Although computed tomography is the most effective method for recognition of this lesion, vertebral angiography may be mandatory for more accurate localization. (orig.)

174

Acute spinal subdural hematoma in a patient with active systemic lupus erythematosus: a case report and literature review.  

Science.gov (United States)

We herein describe a case of acute spinal subdural hematoma (SSDH) during the administration of high-dose corticosteroids and intravenous heparin for the treatment of active lupus nephritis. After SSDH was promptly diagnosed using magnetic resonance imaging (MRI), the patient recovered well with conservative treatment involving the discontinuation of heparin sodium. Although SSDH is a rare complication, it should be considered as a cause of neurological manifestations in patients with active systemic lupus erythematosus. PMID:24739612

Akita, Koji; Wada, Taishi; Horii, Shunpei; Matsumoto, Mitsuyo; Adachi, Takeshi; Kimura, Fumihiko; Itoh, Kenji

2014-01-01

175

A case of diffuse hemispheric gyral high density on CT scan following acute subdural hematoma in children  

International Nuclear Information System (INIS)

A case of diffuse hemispheric gyral high density area following acute subdural hematoma was reported. A 2 - 10/12 year-old male was admitted to our hospital in comatous state after head injury by fall. Neurological examination revealed deep coma with anisocoria (R < L), absence of light reflex and positive bilateral Babinski reflex. CT scan disclosed left acute subdural hematoma with remarkable midline shift and tentorial herniation sign. Emergency decompressive craniectomy was performed. Posttraumatic hydrocephalus appeared after 10 days. So, ventriculoperitoneal shunt was done. The patient became gradually improved, but was in appalic state. 23 days after craniectomy, suddenly diffuse hemispheric gyral high density appeared on plain CT scan. In spite of this change, no clinical change was found. This high density spontaneously disappeared 10 days after appearance. Cerebral infarction-like phenomenon on postoperative CT scan of acute subdural hematoma in infants was sometimes reported. This phenomenon was sometimes accompanied with hemorrhagic infarction-like high density on CT scan. Diffuse hemispheric gyral high density was probably a kind of those hemorrhagic infarction-like phenomenon. Possible mechanism of this peculiar high density is discussed on the basis of characteristics of child's cerebral artery and pathophysiology of cerebral infarction. (author)

176

Acute subdural hematoma following halo pin tightening in a patient with bilateral vertebral artery dissection.  

Science.gov (United States)

We report the first case of acute subdural hematoma (SDH) developing after tightening the halo of an osteoporotic 61-year-old woman on warfarin therapy for bilateral traumatic vertebral artery dissection. We discuss literature relevant to this case with an emphasis on identifying warning signs, including recurrent pin loosening, especially in patients with compromised bone structure and high risk of bleeding. Our 61-year-old patient presented to neurosurgery clinic for a 2-month follow-up of a type-III odontoid fracture sustained in a motor vehicle accident. The patient had repeatedly loosened halo pins, and shortly after the pins were tightened, the patient had a syncopal event and struck her head. An emergent computed tomography scan revealed acute SDH requiring emergent craniotomy and evacuation. SDH following pin penetration in a patient with bilateral vertebral artery dissection, osteoporosis, and anticoagulation has not been reported as a complication of the use of the halo vest for stabilization of the cervical spine. The risk of this serious complication can be minimized by giving special consideration to patients with comorbidities and by repositioning problematic pins. This case demonstrates the importance of special attention to bone strength, bleeding risk, and recurrent minor complaints with use of the halo vest. PMID:22989701

Medhkour, A; Massie, L; Horn, M

2012-12-01

177

Motor vehicle crash-related subdural hematoma from real-world head impact data.  

Science.gov (United States)

Abstract Approximately 1,700,000 people sustain a traumatic brain injury (TBI) each year and motor vehicle crashes (MVCs) are a leading cause of hospitalization from TBI. Acute subdural hematoma (SDH) is a common intracranial injury that occurs in MVCs associated with high mortality and morbidity rates. In this study, SDH volume and midline shift have been analyzed in order to better understand occupant injury by correlating them to crash and occupant parameters. Fifty-seven head computed tomography (CT) scans were selected from the Crash Injury Research Engineering Network (CIREN) with Abbreviated Injury Scale (AIS) level 3+ SDH. Semi-automated methods were used to isolate the intracranial volume. SDH and additional occupant intracranial injuries were segmented across axial CT images, providing a total SDH injury volume. SDH volume was correlated to crash parameters and occupant characteristics. Results show a positive correlation between SDH volume and crash severity in near-side and frontal crashes. Additionally, the location of the resulting hemorrhage varied by crash type. Those with greater SDH volumes had significantly lower Glasgow Coma Scale (GCS) scores at the crash site in near-side crashes. Age and fracture type were found to be significant contributors to SDH volume. This study is a volumetric analysis of real world brain injuries and known MVC impacts. The results of this study demonstrate a relationship among SDH volume, crash mechanics, and occupant characteristics that provide a better understanding of the injury mechanisms of MVC-associated TBI. PMID:22928543

Urban, Jillian E; Whitlow, Christopher T; Edgerton, Colston A; Powers, Alexander K; Maldjian, Joseph A; Stitzel, Joel D

2012-12-10

178

Preoperative-induced mild hypothermia attenuates neuronal damage in a rat subdural hematoma model.  

Science.gov (United States)

Post-traumatic hypothermia has been effective for traumatic brain injury in the laboratory setting. However, hypothermia has not shown efficacy in clinical trials. With the results of a recent clinical trial, we hypothesized that hypothermia might reduce neuronal damage in acute subdural hematoma (ASDH) by blunting the effects of reperfusion injury. Twenty rats were induced with ASDH and placed into one of four groups. The normothermia group was maintained at 37 °C throughout. In the early hypothermia group, brain temperature was reduced to 33 °C 30 min prior to craniotomy. In the late hypothermia group, brain temperature was lowered to 33 °C 30 min after decompression. The sham group had no ASDH and underwent only craniotomy with normothermia. For estimation of glial and neuronal cell damage, we analyzed serum and microdialysate (using a 100kD probe) concentrations of: glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl--terminal hydrolase -L1 (UCH-L1). Hypothermia induced early significantly reduced the concentration of MD UCH-L1. In conclusion, hypothermia induced early may reduce neuronal cell damage in the reperfusion injury, which was induced after ASDH removal. MD UCH-L1 seems like a good -candidate for a sensitive microdialysate biomarker for -neuronal injury and outcome. PMID:23564108

Yokobori, Shoji; Bullock, Ross; Gajavelli, Shyam; Burks, Stephen; Mondello, Stefania; Mo, Jixiang; Wang, Kevin K W; Hayes, Ronald L; Bramlett, Helen; Dietrich, Dalton

2013-01-01

179

Intracranial subdural hematoma as a cause of postoperative delirium and headache in cervical laminoplasty: A case report and review of the literature  

Science.gov (United States)

Objectives To describe a rare case of acute intracranial subdural hematoma as a cause of postoperative delirium and headache following cervical spine surgery. Summary of Background Data Headache is uncommon following spinal surgery, but can be observed in cases of accidental tearing of the dura during surgery. The causes of headache after surgery are thought to include dural tear and CSF leakage. On the other hand, intracranial subdural hematoma can be a cause of headache and cognitive dysfunction. However, only 4 cases as a postoperative complication of spinal surgery have been reported in the literature. Methods A 55-year-old man underwent re-explorative surgery due to postoperative hematoma causing hemiplegia following cervical laminoplasty. During this operation, accidental dural tear occurred and induced CSF leakage. On the following day, headache and delirium were noted. CSF leakage continued despite intraoperative repair of the dural laceration. Cranial CT at that time clearly demonstrated subdural hematoma. Results We reexplored the surgical site and attempted to stop the CSF leakage with meticulous suturing of the dural sac under microscopic observation. The intracranial subdural hematoma was carefully observed under consultation with a specialist neurosurgeon. Following this reexploration, the headache and delirium gradually improved, with spontaneous resolution of intracranial hematoma over a two-month period of observation. Conclusions We have reported a rare case of acute intracranial subdural hematoma caused by CSF leakage following cervical spine surgery. This report demonstrates the possibility of intracranial hematoma as a cause of postoperative cognitive dysfunction or headache, especially when accidental tearing of the dura has occurred in spinal surgery.

Habunaga, Hiroshi; Nakamura, Hiroaki

2011-01-01

180

Computed tomography of acute subdural hematomas from intracranial aneurysmal ruptures, as seen in relation to angiographic and clinical findings  

International Nuclear Information System (INIS)

Nine cases of acute subdural hematomas, as demonstrated by CT, resulting from cerebral aneurysmal ruptures were reviewed in a series of 450 cases of ruptured aneurysms between January, 1977, and December, 1985. They consisted of two males and seven females ranging in age from 36 to 66 years. Their CT examinations were performed from within 20 minutes to 17 hours from the onset. 1) From CT, cerebral angiographical, surgical, and/or autopsy findings, four of these cases were found to have ruptured aneurysms on the internal carotid artery, two on the middle cerebral artery, and three on the anterior cerebral artery. 2) Seven (78 %) of the cases showed a large aneurysm. 3) In addition to subdural hematomas with variable degrees of thickness and extension, intracerebral hemorrhage was present in all nine cases (100 %), ruptured intraventricular hemorrhage, in two (22 %), and subarachnoid hemorrhage, in six (67 %). 4) On admission, six cases (67 %) were in Grade IV and three (33 %) in Grade V, according to the classification of Hunt and Kosnik. Eight (89 %) had anisocoria, four (44 %) had decerebrate posture, and six (67 %) had fundal hemorrhage. 5) As to the outcome, six (67 %) of these cases died, while three (33 %) are still alive. Two of the survivors are in ADL 5, and one, in ADL 2. All of the fatalities and none of the survivors presented fundal hemorrhage. 6) Therefore, in the case of an acute subdural hematoma from an aneurysmal rupture it may be suggested that the smal rupture it may be suggested that the evaluation of the primary brain damage, for which other, accompanying intracranial hemorrhages are also responsible, is important for prognosis and management. (author)

181

Computerized tomography findings of acute traumatic epidural hematoma  

International Nuclear Information System (INIS)

During four year period from April, 1977 to March, 1981, 53 cases with acute traumatic epidural hematoma had been encountered out of 430 acute head injured patients examined by computerized tomography (CT) within 24 hours after incurring the trauma. Besides the initial CT, the authors performed contrast enhanced CT (41 cases) and serial CT scanning (31 cases). There were 49 cases of epidural hematoma existing in the supratentorial region, Two cases infratentorial region and 2 cases in the both regions. Two cases of vertex epidural hematoma had been encountered, one of them required vertical scan technique. In 22 (41%) of the 53 patients, the initial CT showed evidence of other cerebral lesions. The most frequent lesion was pneumocephalus (11 cases), 3 cases of them existed in the epidural hematoma. There were also intracerebral hematoma (6 cases), subdural hematoma (4 cases), cerebral contusion (2 cases), intraventricular hemorrhage (2 cases) and 2 cases of them demonstrated ''diffuse traumatic cerebral injury''. During contrast enhanced CT, 11 cases out of 41 cases indicated several enhancement pattern. There were total enhancement of epidural hematoma (2 cases), partial enhancement of hematoma (2 cases) and enhancement of internal margin of hematoma (2 cases). Serial CT scans was performed in 36 out of the 53 patients. Common findings on the serial CT scans were decreased density collection in the subdural space such as subdural effusions or chronic subdural hematomural effusions or chronic subdural hematomas (8 cases) and enlargement of small epidural hematomas (3 cases). After evacuation of epidural hematoma, there were some cases showing the so-called ''delayed traumatic intracerebral hematoma'' (4 cases), appearance of other epidural hematoma (1 case) and development of small cerebral infarction in the basal ganglia. There was one case indicating appearance of a new epidural hematoma contra lateral to the side of evacuation of subdural hematoma. (J.P.N.)

182

Rapid resolution of an acute subdural hematoma by increasing the shunt valve pressure in a 63-year-old man with normal-pressure hydrocephalus with a ventriculoperitoneal shunt: a case report and literature review  

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Full Text Available Abstract Introduction Symptomatic subdural hematoma development is a constant concern for patients who have undergone cerebrospinal fluid shunting procedures to relieve symptoms related to normal-pressure hydrocephalus. Acute subdural hematomas are of particular concern in these patients as even minor head trauma may result in subdural hematoma formation. The presence of a ventricular shunt facilitates further expansion of the subdural hematoma and often necessitates surgical treatment, including subdural hematoma evacuation and shunt ligation. Case presentation We present the case of a 63-year-old North American Caucasian man with normal-pressure hydrocephalus with an adjustable valve ventriculoperitoneal shunt who developed an acute subdural hematoma after sustaining head trauma. Conservative treatment was favored over operative evacuation because our patient was neurologically intact, but simple observation was considered to be too high risk in the setting of a low-pressure ventriculoperitoneal shunt. Thus, the valve setting on the ventriculoperitoneal shunt was increased to its maximum pressure setting in order to reduce flow through the shunt and to mildly increase intracranial pressure in an attempt to tamponade any active bleeding and limit hematoma expansion. A repeat computed tomography scan of the head six days after the valve adjustment revealed complete resolution of the acute subdural hematoma. At this time, the valve pressure was reduced to its original setting to treat symptoms of normal-pressure hydrocephalus. Conclusions Programmable shunt valves afford the option for non-operative management of acute subdural hematoma in patients with ventricular shunts for normal-pressure hydrocephalus. As illustrated in this case report, increasing the shunt valve pressure may result in rapid resolution of the acute subdural hematoma in some patients.

Hayes Jackson

2012-11-01

183

Conservative management of subdural hematoma in idiopathic thrombocytopenic purpura: Report of two cases and review of literature  

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Full Text Available Intracranial hemorrhage (ICH is the most serious complication of idiopathic thrombocytopenic purpura (ITP and is potentially fatal. It is rare, affecting 1% or less of patients and is usually subarachnoid or intracerebral. Isolated subdural hematoma (SDH is rare and only few cases have been reported. Two cases of acute SDH (ASDH are reported which resolved with conservative management. One of the patients later developed intracerebral hematoma also. In ITP, contrary to traumatic ASDH, the brain parenchyma is well preserved and hence conservative management may be safe in selected patients. However, only a prospective randomized control study will give the final answer. Both the patients developed the hematoma consequent to low platelet count, which was not detected earlier due to inadequate follow-up. In a developing country, where proper follow-up is often lacking these problems are likely to be more common and are probably underreported. Increased awareness is therefore important to ensure proper follow-up and early intervention.

Sunitha R

2007-01-01

184

Computerized tomography findings of acute traumatic epidural hematoma  

Energy Technology Data Exchange (ETDEWEB)

During four year period from April, 1977 to March, 1981, 53 cases with acute traumatic epidural hematoma had been encountered out of 430 acute head injured patients examined by computerized tomography (CT) within 24 hours after incurring the trauma. Besides the initial CT, the authors performed contrast enhanced CT (41 cases) and serial CT scanning (31 cases). There were 49 cases of epidural hematoma existing in the supratentorial region, Two cases infratentorial region and 2 cases in the both regions. Two cases of vertex epidural hematoma had been encountered, one of them required vertical scan technique. In 22 (41%) of the 53 patients, the initial CT showed evidence of other cerebral lesions. The most frequent lesion was pneumocephalus (11 cases), 3 cases of them existed in the epidural hematoma. There were also intracerebral hematoma (6 cases), subdural hematoma (4 cases), cerebral contusion (2 cases), intraventricular hemorrhage (2 cases) and 2 cases of them demonstrated ''diffuse traumatic cerebral injury''. During contrast enhanced CT, 11 cases out of 41 cases indicated several enhancement pattern. There were total enhancement of epidural hematoma (2 cases), partial enhancement of hematoma (2 cases) and enhancement of internal margin of hematoma (2 cases). Serial CT scans was performed in 36 out of the 53 patients. Common findings on the serial CT scans were decreased density collection in the subdural space such as subdural effusions or chronic subdural hematomas (8 cases) and enlargement of small epidural hematomas (3 cases). After evacuation of epidural hematoma, there were some cases showing the so-called ''delayed traumatic intracerebral hematoma'' (4 cases), appearance of other epidural hematoma (1 case) and development of small cerebral infarction in the basal ganglia. There was one case indicating appearance of a new epidural hematoma contra lateral to the side of evacuation of subdural hematoma. (J.P.N.).

Kobayashi, Shiro; Nakazawa, Shozo; Yokota, Hiroyuki; Yajima, Kouzo; Yano, Masami; Otsuka, Toshibumi

1984-12-01

185

CT findings of subdural fluid collections and the histology of the organized neomembrane, (1)  

International Nuclear Information System (INIS)

Recently it has been reported that, among cases of subdural fluid collection with a low CT density with several weeks after injury, some of the cases developed a chronic subdural hematoma at the same location several months later. On its pathogenesis, it is assumed that the isolated fluid collection between the dura and arachnoid forms a neomembrane and then develops a chronic subdural hematoma. Based upon our 4 cases of subdural fluid collection, we pointed out that the following conditions of subdural low-density lesions are difficult to differentiate from subdural hydroma at the early stage of injury: (1) The existence of a very old chronic subdural hematoma that might have been formed before the recent injury. (2) The occurrence of a minor hemorrhage into the subdural-fluid collection at the time of injury, which is indistinguishable on the CT scan. Therefore, the present authors considered it necessary to investigate the histology of the hematoma membrane in order to make clear the formation process of neomembrane and to compare the relation between the aging of neomembrane and the time interval of injury and CT examination. We consider the histological study very useful to reveal the pathogenesis of a chronic subdural hematoma, for it will make clear the following points: (1) Whether the neomembrane had already been formed prior to the recent head injury, (2) Whether the neomembrane was formed newly due to minor hemorrhage into the subdural fluid collection, andge into the subdural fluid collection, and (3) Whether the formation of the neomembrane is possible simply from subdural-fluid collection isolated from the CSF pathway. (author)

186

Acute subdural hematoma without subarachnoid hemorrhage caused by ruptured A1-A2 junction aneurysm. Case report.  

Science.gov (United States)

A 54-year-old man was admitted to our hospital with complaint of sudden headache. The patient had suffered two episodes of transient headache before admission. Computed tomography (CT) revealed acute subdural hematoma (ASDH) on the right side of the cerebral convexity with bilateral extension along the tentorium cerebelli without signs of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH). Three-dimensional CT angiography and conventional cerebral angiography revealed a left A1-A2 junction aneurysm. Neck clipping of the aneurysm was performed. The aneurysm extended inferiorly, with the dome embedded in the chiasmatic cistern and tightly adhered to the arachnoid membrane. There was no evidence of hematoma in the subarachnoid space. The patient was discharged without neurological deficit. Ruptured aneurysms resulting in ASDH without SAH or ICH are very rare. Radiological investigation such as three-dimensional CT angiography should be performed to find the causative aneurysm in a patient with ASDH with a history of repeated headaches and without traumatic signs or episodes, and the appropriate treatment should be planned with expediency. PMID:22729076

Takada, Tomoya; Yamamoto, Tetsuya; Ishikawa, Eiichi; Zaboronok, Alexander; Kujiraoka, Yuji; Akutsu, Hiroyoshi; Ihara, Satoshi; Nakai, Kei; Matsumura, Akira

2012-01-01

187

Clinical features, treatment and outcome of the acute subdural hematoma in JNTDB. Comparison between Project 1998 and Project 2004  

International Nuclear Information System (INIS)

The purpose of this study was clarify the clinical features, a change of the therapy and the effect, connection with the outcome of acute subdural hematoma registered on the Japan Neurotrauma Data Bank (JNTDB) presented in 1998 and 2004. Among those, 421 cases in P1998 and 380 cases in P2004 aged more than 6 years who presented with Glasgow Coma Scale (GCS) 8 or less on admission and with acute subdural hematoma (ASDH) on CT findings were retrospectively analyzed. As for the age distribution, two peaks were seen in young aged 16-20 years and old aged 61-65 years. The ratio of the ASDH case in young cases (45 years) decreased compared with P1998. A ratio of traffic accidents decreased, and a ratio of the injury by the fall increased. Surgical treatment was performed to 63.2% (P2004), 65.1% (P1998), and was performed both projects most together by a 46-65 year-old case. Hematoma evacuation group increased to 21.1% from 14.5%, and a burr hole opening decreased to 17.1% (P2004) from 22.3% (P1998). The temperature management was performed to 41.2% (P2004), 20.5% (P1998), especially the younger cases (45 years) in P2004, the temperature management was performed to 56.2%. The overall mortality is 67.7% (P1998), and 54.5% (P2004). The mortality of the temperature management cases was decreased, but the favorable outcome group does not increase. In younger cases (45 years), the favorable outcome group improved to 47.1% (P2004) from 33.3% (P1998) in the hypothermia group, and i3% (P1998) in the hypothermia group, and improved to 45.5% (P2004) from 30.0% (P1998) in the normothermia group. Temperature management after surgical treatment was more common, used to 57.5% (P2004) and 29.2% (P1998). The rate of favorable outcome group tends to increase in the hypothermia and normothermia group with craniotomy, but the mortality was not seen in the difference with the no temperature management group. For the case that used temperature management with a burr hole opening, the effect was not clear. An outcome tends to be good for the case that used temperature management together with craniotomy and will require the accumulation of the further case in future. (author)

188

Rapid spontaneous resolution of acute subdural haematoma in a patient with chronic alcoholism.  

Science.gov (United States)

Acute subdural haematoma (ASDH) constitutes one of the most critical emergencies in neurosurgery. There are only several reports that show the rapid disappearance of ASDH without surgical intervention. We report a case of a 64-year-old alcoholic man who had a traumatic subdural haematoma after a fall from a height of about eight meters on level ground. The computed tomography (CT) of the brain on admission demonstrated a left parietooccipital ASDH. A follow-up CT scan after 8 hours showed resolution of the hematoma. The patient was discharged 9 days later with no neurological deficit. We discuss the possible mechanisms of the rapid resolution of the ASDH. PMID:22111954

Hadjigeorgiou, Georgios; Chamilos, Christos; Petsanas, Adamantios; Vranos, Georgios; Foteas, Pavlos; Spiridakis, Filokypros

2012-06-01

189

A prospective randomised study to compare the utility and outcomes of subdural and subperiosteal drains for the treatment of chronic subdural haematoma.  

LENUS (Irish Health Repository)

The usage of a drain following evacuation of a chronic subdural haematoma (CSDH) is known to reduce recurrence. In this study we aim to compare the clinical outcomes and recurrence rate of utilising two different types of drains (subperiosteal and subdural drain) following drainage of a CSDH.

Kaliaperumal, Chandrasekaran

2012-11-01

190

Simultaneous appearance of cerebral venous thrombosis and subdural hematomas as rare cause of headache in puerperium following epidural analgesia: a case report  

OpenAIRE

The aim of this study is to report the first case of simultaneous appearance of cerebral venous thrombosis (CVT) and bilateral subdural hematomas (SDHs) following epidural analgesia for labor and delivery and to point out the difficulty of establishing such a diagnosis in the presence of postpartum headache. A 26-year old primigravida with a history of epilepsy received epidural analgesia for delivery. Three days after the uneventful spontaneous vaginal delivery she complained about the heada...

Z?upan, Z?eljko; Sotos?ek Tokmadz?ic?, Vlatka; Matanic?-manestar, Marinka; S?ustic?, Alan; Antonc?ic?, Igor; Dunatov, Sinis?a; Pavlovic?, Ivan; Antulov, Ronald

2012-01-01

191

Second-Impact Syndrome and a Small Subdural Hematoma: An Uncommon Catastrophic Result of Repetitive Head Injury with a Characteristic Imaging Appearance  

OpenAIRE

There have been a handful of previously published cases of athletes who were still symptomatic from a prior head injury, and then suffered a second injury in which a thin, acute subdural hematoma (SDH) with unilateral hemisphere vascular engorgement was demonstrated on CT scan. In those cases, the cause of the brain swelling/dysautoregulation was ascribed to the presence of the acute SDH rather than to the acceleration/deceleration forces that caused the SDH. We believe that the brain swellin...

Cantu, Robert C.; Gean, Alisa D.

2010-01-01

192

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports  

OpenAIRE

Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hemat...

Pillai Promod; Menon Sajesh K; Manjooran Raju P; Kariyattil Rajiv; Pillai Ashok B; Panikar Dilip

2009-01-01

193

[Chronic expanding hematoma of the soleus: a case report].  

Science.gov (United States)

Trauma-induced hematomas of the limbs usually resorb without sequelae. In certain circumstances which are not fully understood, the hematoma may expand progressively, eventually leading to the development of a tumor-like mass in the soft tissues. We report the case of a chronic expanding hematoma observed in the right soleus muscle of a 75-year-old man. The mass grew +9 cm compared with the other side over a period of two to three years with no notion of recent trauma. Surgical biopsy disclosed a thick capsule containing "chocolate pus". Pathology and cytology examination led to the diagnosis of pseudo-tumor calcinosis subsequent to a hematoma which the patient had developed 34 years earlier when as a mountain guide he had experienced a tear of the soleus muscle. Local care required complete resection of the soleus muscle. The patient was able to resume activities without pain. Well described in the literature, encapsulated hematoma of the limbs is not well known in France. This case illustrated the potentially long latency period (34 years in our patient). Pathologically similar to tumor calcinosis, chronic expanding hematoma should be entertained as a possible diagnosis in a patient with a longstanding mass and a history of past trauma. The differential diagnosis with sarcoma is established by magnetic resonance imaging which reveals a peripheral low intensity signal on T1 and T2 sequences. PMID:17124458

Pichon, H; Pittet Barbier, L; Pasquier, B; Cartier, J; Saragaglia, D

2006-11-01

194

Spontaneous cortical spreading depression and intracranial pressure following acute subdural hematoma in a rat.  

Science.gov (United States)

Acute subdural hemorrhage (ASDH) is a frequent and devastating consequence of traumatic brain injury. Tissue damage develops rapidly and makes treatment even more difficult. Management of increased intracranial pressure (ICP) due to extravasated blood volume and brain swelling is often insufficient to control all adverse effects of ASDH. In addition to sheer volume, spontaneously triggered cortical spreading depression (CSD) that leads to cell death following ischemia or trauma may contribute to injury development after ASDH. Therefore, we explored the occurrence of CSD by tissue impedance (IMP) measurement in a rat model subjected to ASDH. IMP and intraventricular and mean arterial pressure were monitored before (baseline), during (blood infusion), and after ASDH for 3 h.Tissue impedance increased by around 203% of baseline during subdural infusion of 300 ?l of autologous, venous blood and dropped back to baseline within 22 min. Fifty-six minutes after the start of ASDH a cluster of four short-lasting (3-3.5 min; 140-160% of baseline) IMP increases started that reflected spontaneous CSDs. This pattern presumes that CSD occurs early after ASDH and therefore may contribute to the rapid lesion development in this disease. PMID:22327726

Alessandri, B; Tretzel, J Stephan; Heimann, Axel; Kempski, Oliver

2012-01-01

195

Subdural hematomas in pulmonary arterial hypertension patients treated with prostacyclin analogs  

OpenAIRE

Prostacyclin analogs therapy has been associated with development of thrombocytopenia. Little is known whether this treatment increases the risk of intracranial hemorrhage in pulmonary artery hypertension (PAH) patients. We queried the Cleveland Clinic billing database to identify cases of nontraumatic sudural hematoma (SDH) in patients with PAH. We identified those individuals who were receiving prostacyclin analogs therapy at the time of the neurological event and assessed whether these pat...

Louis, Lam; Bair, Nancy; Banjac, Svetlana; Dweik, Raed A.; Tonelli, Adriano R.

2012-01-01

196

Recurrence of chronic subdural haematomata with and without post-operative drainage  

DEFF Research Database (Denmark)

Chronic subdural haematoma is a common disease causing morbidity and mortality. Recurrence after surgical treatment is common, varying from 5% to 30% of cases. Several methods for reducing recurrence have been advocated. The aim of this study was to investigate the effect of post-operative subdural drainage. Three hundred forty-four patients were included in a retrospective study. Treatment was performed by burr hole irrigation. Groups were separated into those with post-operative drainage compared to those without. Recurrence occurred in 14% in the drained group, significantly less than 26% in the undrained group (p=0.011). There were no differences in the complication rates. Post-operative drainage reduces recurrence of chronic subdural haematoma without increasing the complication rate. These results support those reported in several other studies. We recommend the use of post-operative subdural drainage.

Carlsen, Jakob G; Cortnum, SØren

2011-01-01

197

The influence of coagulopathy on outcome after traumatic subdural hematoma: a retrospective single-center analysis of 319 patients.  

Science.gov (United States)

The aim of this study was to identify the effects of coagulopathy on the outcome of patients with traumatic subdural hematoma (SDH). Based on a retrospective study, the records of all patients admitted between 2001 and 2007 to a large emergency hospital with acute SDH resulting from traumatic brain injury (TBI) were analyzed. An initial Glasgow coma score (GCS), clinical state, and Glasgow outcome score (GOS) were recorded for all patients. All computer assisted tomography and MRI scans obtained from patients were saved on an electronic storage device and were reviewed by a neurosurgeon and a neuroradiologist. The coagulation parameters were analyzed for all patients. Coagulopathy was defined as international normalized ratio more than 1.2 or partial thromboplastin time more than 37?s. One hundred and five women and 214 men aged between 1 and 100 years (mean 59 years) were included in the study. Patients with coagulopathy had a significantly worse outcome. Almost twice as many patients died in the coagulopathy group (mean GOS 3.10?±?1.46) than in the group without coagulopathy (mean GOS 2.16?±?1.45), (P?

Lemcke, Johannes; Al-Zain, Ferass; von der Brelie, Christian; Ebenau, Martina; Meier, Ullrich

2014-06-01

198

Traumatic subdural hygroma: five cases with changed density and spontaneous resolution Higroma subdural traumático: a propósito de cinco casos com modificação de densidade e resolução espontânea  

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Full Text Available Thirty-four consecutive adult patients with subdural traumatic hygroma were analysed for clinical evolution, serial computed tomography scan (CT, and magnetic resonance imaging (MRI over a period of several months. Five of the patients presented CT scan and MRI evolution data showing increasing density over a period of 11 days to 6 months post trauma. In these five patients, final clinical and CT scan data were benign, with complete spontaneous resolution. Descriptions in literature of evolving traumatic subdural hygroma have presented CT scan density modifications changing into chronic subdural hematoma. Our patients show another possibility, density transformation, which sometimes show as subdural hematoma in CT scan and MRI, but with final evolution where clinical condition and CT scan return to normal.Analisamos 34 pacientes adultos com higroma subdural traumático quanto à evolução clínica, tomografias seriadas e ressonância magnética. Observou-se aumento da densidade do higroma subdural em cinco dos pacientes durante período que variou de 11 dias a 6 meses após o trauma. Nestes cinco pacientes, a evolução clínica foi favorável e os higromas apresentaram resolução espontânea. Há vários relatos na literatura de modificação da densidade dos higromas subdurais tramáticos, transformando-se em hematoma subdural crônico. Esta casuística apresenta outra possibilidade, ou seja, modificação da densidade, que pode ser apresentada como hematoma subdural pelas imagens de tomografia ou ressonância magnética, mas com resultado final das condições clínicas e de imagem retornando ao normal.

Marco Antonio Zanini

2007-03-01

199

Chronic nontraumatic spinal epidural hematoma of the lumbar spine: MRI diagnosis  

International Nuclear Information System (INIS)

An uncommon case of chronic nontraumatic spinal epidural hematoma of the lumbar spine in a 75-year-old woman is reported. The patient presented with a 7-month history of low back pain and bilateral sciatica. Magnetic resonance imaging enabled a correct preoperative diagnosis revealing a nodular, well-circumscribed epidural mass with peripheral enhancement and signal intensities consistent with chronic hematoma, which extended from L2 to L3. Laminectomy of L2-L3 was performed and the hematoma was totally resected. Histological examination of the surgical specimen demonstrated a chronic encapsulated hematoma. No evidence of vascular malformation was found. The patient recovered fully after surgical treatment. (orig.)

200

Chronic nontraumatic spinal epidural hematoma of the lumbar spine: MRI diagnosis  

Energy Technology Data Exchange (ETDEWEB)

An uncommon case of chronic nontraumatic spinal epidural hematoma of the lumbar spine in a 75-year-old woman is reported. The patient presented with a 7-month history of low back pain and bilateral sciatica. Magnetic resonance imaging enabled a correct preoperative diagnosis revealing a nodular, well-circumscribed epidural mass with peripheral enhancement and signal intensities consistent with chronic hematoma, which extended from L2 to L3. Laminectomy of L2-L3 was performed and the hematoma was totally resected. Histological examination of the surgical specimen demonstrated a chronic encapsulated hematoma. No evidence of vascular malformation was found. The patient recovered fully after surgical treatment. (orig.)

Vazquez-Barquero, A.; Pinto, J.I. [Univ. Hospital ' ' Marques de Valdecilla' ' , Santander (Spain). Dept. of Neurosurgery; Abascal, F.; Garcia-Valtuille, R.; Cerezal, L. [Hospital Mompia, Cantabria, (Spain). Dept. of Radiology; Figols, F.J. [Univ. Hospital Marques de Valdecilla, Santander (Spain). Dept. of Pathology

2000-10-01

201

Spontaneously Rapid Resolution of Acute Subdural Hemorrhage with Severe Midline Shift  

OpenAIRE

Acute subdural hematoma is usually a neurological emergency that requires hematoma evacuation or close observation. However, spontaneous resolutions of an acute subdural hematoma without surgical interventions have been reported rarely. We report on a case who showed rapid resolution of an acute subdural hematoma with neurological improvement and review the relevant literatures.

Shin, Dong-won; Choi, Chan-young; Lee, Chae-heuck

2013-01-01

202

Spontaneous subdural hematoma in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia with normal platelet count after dasatinib treatment.  

Science.gov (United States)

Abstract Dasatinib, which is an inhibitor of BCR-ABL and SRC family tyrosine kinases, is used for the treatment of patients with Philadelphia chromosome (Ph) positive leukemia, especially for those who develop resistance or who are intolerant to imatinib. The most common adverse effects attributed to its use are: myelosuppression, nausea, diarrhea, and peripheral edema. Hemorrhage, which could be gastrointestinal, genitourinary or central nervous system, is a less frequent adverse effect. In this case, we report a patient affected by precursor B-cell acute lymphoblastic leukemia (ALL) positive for the Ph chromosome translocation treated with the tyrosine kinase inhibitor (TKI) dasatinib. During the treatment with dasatinib the patient developed subdural hematoma (SDH). She did not have any head trauma, thrombocytopenia, coagulopathy or meningeal involvement, making dasatinib-induced platelet dysfunction the most likely cause of SDH. PMID:25025538

Mustafa Ali, Moaath K; Sabha, Marwa M; Al-Rabi, Kamal H

2014-07-15

203

Post-traumatic subdural hygroma  

International Nuclear Information System (INIS)

Full text: Introduction: Post-traumatic subdural hygroma (PSH) refers to a relatively common complication of blunt head trauma that consists in cerebrospinal fluid accumulation in the subdural space. Objectives and tasks: The aim of this case presentation is to briefly outline the clinical and imaging signs, the natural history and clinical significance of PSH. Material and methods: An 85-year-old, female patient was admitted to the emergency department with loss of consciousness after falling on the ground. The patient underwent an emergency head CT scan that didn't show any haemorrhagic findings or fractures and the woman was transferred to the Internal Medicine Department with the assumed diagnosis of an ischaemic cerebral stroke. Results: A new CT scan, 3 days later,confirmed the above diagnosis showing a low-density lesion in the area of left basal ganglia. The presence of an ipsilateral subdural parietal fluid accumulation with a density near to cerebrospinal fluid was also noticed. This new finding was compatible with PSH. Conclusion: PSH frequently appears as a late post-traumatic complication missing clinical attention. In most cases, it's treated conservatively because it's usually self-limited.Very rarely, PSH may be large enough to cause mass effect and may require surgical decompression. The entity should be differentiated from chronic subdural hematoma and cerebral atrophy with dilation of the subarachnoid spaces

204

Chronic expanding hematoma of the thigh simulating neoplasm on gadolinium-enhanced MRI  

International Nuclear Information System (INIS)

Patients who present with slowly growing extremity masses are often imaged with MRI to be examined for possible tumors. In addition to cysts and neoplasms, chronic expanding hematomas should be considered in the differential diagnosis if the patient has a history of remote trauma. The presence or absence of internal contrast enhancement is often used to distinguish between hematomas and hemorrhagic neoplasms on MRI and CT. We present the unusual case of a patient who had a chronic expanding hematoma of the calf that demonstrated nodular internal enhancement on gadolinium-enhanced MRI, simulating a neoplasm. (orig.)

205

Uncoupling between CBF and oxygen metabolism in a patient with chronic subdural haematoma: case report.  

OpenAIRE

The regional cerebral blood flow (rCBF) and oxygen metabolism of a patient with a chronic subdural haematoma were examined quantitatively, using positron emission tomography (PET). Before operation, the rCBF was decreased slightly throughout the brain, whereas the regional oxygen extraction fraction (rOEF) was increased throughout the brain, with values ranging from 0.36 to 0.60. One month after operation, the rCBF had recovered remarkably in almost all regions and rOEF had decreased to withi...

Ishikawa, T.; Kawamura, S.; Hadeishi, H.; Suzuki, A.; Yasui, N.; Shishido, F.; Uemura, K.

1992-01-01

206

Chronic pure radiculopathy in patient with organizing epidural hematoma around C8 nerve root  

OpenAIRE

Spontaneously occurring spinal epidural hematomas are uncommon clinical findings, and the chronic form is the rarest and its most frequent location is the lumbar spine. Pure radicular involvement is far less frequent than myelopathy. We report a case of progressive radiculopathy in a 52-year-old man with spontaneously occurring cervical epidural hematoma (SCEH). The patient had left hand weakness and numbness for 4 months. MRI scan showed small space-occupying lesion around left 8th cervical...

Kim, Sang-hyuk; Jeon, Sang-ho; Cho, Jae-lim; Chong, Hung-tae; Kim, Dong-jun; Kim, Moon-chan; Eun, Jong-pil

2012-01-01

207

Acute subdural hematoma and diffuse axonal injury in fatal road traffic accident victims: a clinico-pathological study of 15 patients Hematoma subdural agudo e lesão axonal difusa em vítimas fatais de acidente de trânsito: estudo clínico-patológico de 15 pacientes  

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Full Text Available 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.OBJETIVO: Embora o hematoma subdural agudo (HSDA e a lesão axonal difusa (LAD estejam frequentemente associados em vítimas de trauma crânio-encefálico causado por acidentes de trânsito, há somente dois estudos clínico-patológicos sobre esta associação. Relatamos o estudo clínico-patológico de 15 pacientes com HSDA associado com LAD. MÉTODO: Os pacientes, vítimas de acidentes de trânsito, foram selecionados aleatoriamente. O estado de consciência à admissão hospitalar foi avaliado pela escala de coma de Glasgow. Para a identificação dos axônios, os cortes histológicos do cérebro foram corados com antisoro anti-proteínas do neurofilamento. RESULTADOS: Doze dos 15 pacientes foram admitidos no hospital em estado de coma; em três pacientes, o nível de consciência não foi avaliado, pois eles faleceram antes da admissão hospitalar. CONCLUSÃO: O pior prognóstico em pacientes com HSDA que apresentam coma imediatamente após serem admitidos por trauma crânio-encefálico, como descrito por vários autores, pode ser explicado pela quase que constante associação entre HSDA e LAD em vítimas fatais de acidentes de trânsito.

Sebastião Nataniel Silva Gusmão

2003-09-01

208

Acute subdural hematoma and diffuse axonal injury in fatal road traffic accident victims: a clinico-pathological study of 15 patients / Hematoma subdural agudo e lesão axonal difusa em vítimas fatais de acidente de trânsito: estudo clínico-patológico de 15 pacientes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Embora o hematoma subdural agudo (HSDA) e a lesão axonal difusa (LAD) estejam frequentemente associados em vítimas de trauma crânio-encefálico causado por acidentes de trânsito, há somente dois estudos clínico-patológicos sobre esta associação. Relatamos o estudo clínico-patológico de 15 p [...] acientes com HSDA associado com LAD. MÉTODO: Os pacientes, vítimas de acidentes de trânsito, foram selecionados aleatoriamente. O estado de consciência à admissão hospitalar foi avaliado pela escala de coma de Glasgow. Para a identificação dos axônios, os cortes histológicos do cérebro foram corados com antisoro anti-proteínas do neurofilamento. RESULTADOS: Doze dos 15 pacientes foram admitidos no hospital em estado de coma; em três pacientes, o nível de consciência não foi avaliado, pois eles faleceram antes da admissão hospitalar. CONCLUSÃO: O pior prognóstico em pacientes com HSDA que apresentam coma imediatamente após serem admitidos por trauma crânio-encefálico, como descrito por vários autores, pode ser explicado pela quase que constante associação entre HSDA e LAD em vítimas fatais de acidentes de trânsito. Abstract in english 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 ASD [...] H 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.

Sebastião Nataniel Silva, Gusmão; José Eymard Homem, Pittella.

2003-09-01

209

Chronic subdural hematoma in a child with acute myeloid leukemia after leukocytosis  

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Severe complications that develop in the early stages in patients with acute leukemia have a mortal course. Bleeding, leukostasis, and less frequently, infections are responsible for early mortality. Hemorrhage is most common in acute leukemia and usually leads to death. Hemorrhage may occur due to chemotherapy or bone marrow transplantation in patients with acute leukemia. Leukocytosis, thrombocytopenia, sepsis, and coagulopathy increase the risk of bleeding. There may be multiple etiologic ...

Basmaci, Mehmet; Hasturk, Askin E.

2012-01-01

210

FDG-PET imaging for chronic expanding hematoma in pelvis with massive bone destruction  

International Nuclear Information System (INIS)

Chronic expanding hematoma is a rare presentation of a hematoma characterized by a persistent increase in size for more than a month after the initial hemorrhage. We present a 65-year-old man with a chronic expanding hematoma in his ilium who was receiving anticoagulant treatment. The patient had a delayed manifestation of a femoral neuropathy with massive bone destruction. 2-Deoxy-[18F]fluoro-d-glucose (FDG) positron emission tomography (PET) imaging revealed an increased uptake in the rim of the mass in images acquired 1 h after FDG injection. FDG-PET scans were performed using a dedicated PET scanner (HeadtomeV/SET2400 W, Shimadzu, Kyoto, Japan), and the PET data for the most metabolically active region of interest (ROI) were analyzed. The maximum standardized uptake value (SUVmax) was set to a cut-off point of 3.0 to distinguish between benign and malignant lesions. The SUVmax of the patient's lesion was 3.10, suggesting a malignant lesion. The characteristics of FDG-PET images of chronic expanding hematomas, including the uptake of FDG in the peripheral rim of the mass as a result of inflammation, should be recognized as a potential interpretive pitfall in mimicking a sarcoma. (orig.)

211

Chronic expanding hematoma extending over multiple gluteal muscles associated with piriformis syndrome.  

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We report on a patient with an unusual, slowly enlarging hematoma of the left buttock. A 62-year-old man presented with a 6-year history of an enlarging mass of the left buttock. He had first noted the mass 6 years earlier and had had sciatica of the left lower limb for the last 2 months. He denied any history of antecedent trauma. The lesion extended over 3 gluteal muscles (the gluteus medius, gluteus minimus, and piriformis). On microscopic examination, the lesion showed typical signs of chronic expanding hematoma. The sciatica was relieved after surgical removal of the lesion. The lesion had not recurred at the last follow-up 4 years after the operation. The present case suggested that chronic expanding hematoma can extend into multiple muscles due, perhaps, to long-term growth and the anatomical and functional conditions of the affected muscles. Our case also suggests that chronic expanding hematoma can be a cause of piriformis syndrome. PMID:23291848

Kitagawa, Yasuyuki; Yokoyama, Munehiro; Tamai, Kensuke; Takai, Shinro

2012-01-01

212

Myelopathy Caused by Chronic Epidural Hematoma Associated with L1 Osteoporotic Vertebral Collapse: A Case Report and Review of the Literature  

OpenAIRE

Epidural hematoma associated with osteoporotic vertebral collapse has not been reported yet in the literature. We report a case of myelopathy caused by chronic epidural hematoma associated with L1 osteoporotic vertebral collapse and review the relevant literature.

Oda, Itaru; Fujiya, Masanori; Hasegawa, Kyoichi; Terae, Satoshi

2008-01-01

213

Tomografia computadorizada em decúbito ventral e lateral no diagnóstico diferencial entre hematoma subdural e atrofia cortical / Computer assisted tomography in lateral and prone position in the differencial diagnosis between brain atrophy and subdural colections  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A realização da tomografia computadorizada em decúbito lateral ou ventral, pode ser útil no diagnóstico diferencial entre atrofia cerebral e coleção subdural. Alguns casos são apresentados. [...] Abstract in english The differencial diagnosis between brain atrophy versus subdural effusion in children has shown some difficulties in a few cases, mainly when the frontal subarachnoid space is very large on computed tomography. We think that a simple procedure, that is, CT scans in the lateral and prone position fol [...] lowing the standard examination, may be worth to clarify those cases of doultfoull diagnosis.

Eduardo, Bianco; Milton K., Shibata; Gilberto Machado de, Almeida.

1980-09-01

214

Chronic Expanding Hematoma of the Adrenal Gland Mimicking a Hemangioma: A Case Report  

International Nuclear Information System (INIS)

We report a rare case of unilateral chronic expanding hematoma in the left adrenal gland, mimicking a hemangioma on multiphase computed tomography (CT). On CT, the mass showed several enhancing foci of irregular and frond-like shape in the periphery at the hepatic arterial phase and gradual fill-in pattern at the portal venous phase, which was similar with the enhancement pattern of hemangioma.

215

Chronic Expanding Hematoma of the Adrenal Gland Mimicking a Hemangioma: A Case Report  

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We report a rare case of unilateral chronic expanding hematoma in the left adrenal gland, mimicking a hemangioma on multiphase computed tomography (CT). On CT, the mass showed several enhancing foci of irregular and frond-like shape in the periphery at the hepatic arterial phase and gradual fill-in pattern at the portal venous phase, which was similar with the enhancement pattern of hemangioma.

Lee, Hyun Jung; Kim, Min Jeong; Ha, Hong Il; Lee, In Jae; Lee, Kwan Seop; Seo, Jin Won [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of); Yeo, Seung Gu [Dept. of Radiation Oncology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

2013-04-15

216

Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology  

International Nuclear Information System (INIS)

The goal of this work is to describe the radiological appearance and clinical presentation of subperiosteal iliac hematoma and present a review of the literature. We retrospectively reviewed the radiological and clinical files of 19 patients (age range: 12-75; mean: 47) who presented with acute or chronic subperiosteal iliac hematomas. Imaging findings and relevant clinical information were recorded. A thorough literature search was performed to find additional cases of this rare condition. Three young patients presented with acute subperiosteal iliac hematoma following a fall. Clinical presentation was characterized by pain and gait disturbance presumed to result from crural nerve compression. Unilateral or bilateral lenticular hematomas deep in the iliacus muscle were demonstrated by CT for all patients while MRI was also available for two of them. In 16 asymptomatic patients, chronic ossified subperiosteal iliac hematomas were incidentally detected by CT. Progressive ossification of acute hematoma was demonstrated at follow-up in two patients. Subperiosteal iliac hematoma is rare but has typical imaging findings that may present acutely in adolescents or chronically in asymptomatic adults. (orig.)

217

Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology  

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The goal of this work is to describe the radiological appearance and clinical presentation of subperiosteal iliac hematoma and present a review of the literature. We retrospectively reviewed the radiological and clinical files of 19 patients (age range: 12-75; mean: 47) who presented with acute or chronic subperiosteal iliac hematomas. Imaging findings and relevant clinical information were recorded. A thorough literature search was performed to find additional cases of this rare condition. Three young patients presented with acute subperiosteal iliac hematoma following a fall. Clinical presentation was characterized by pain and gait disturbance presumed to result from crural nerve compression. Unilateral or bilateral lenticular hematomas deep in the iliacus muscle were demonstrated by CT for all patients while MRI was also available for two of them. In 16 asymptomatic patients, chronic ossified subperiosteal iliac hematomas were incidentally detected by CT. Progressive ossification of acute hematoma was demonstrated at follow-up in two patients. Subperiosteal iliac hematoma is rare but has typical imaging findings that may present acutely in adolescents or chronically in asymptomatic adults. (orig.)

Guillin, Raphael [Rennes University Hospital, Department of Musculoskeletal Imaging, Rennes Cedex 2 (France); Moser, Thomas [Montreal University Hospital, Department of Musculoskeletal Imaging, Montreal (Canada); Koob, Meriam [Strasbourg University Hospital, Department of Pediatric Imaging, Strasbourg (France); Khoury, Viviane [Mc Gill University Health center, Department of Radiology, Montreal (Canada); Chapuis, Madeleine [Rennes University Hospital, Department of Pediatric Orthopedic Surgery, Rennes (France); Ropars, Mickael [Rennes University Hospital, Department of orthopedic surgery, Rennes (France); Cardinal, Etienne [Radiologie Laennec, Montreal (Canada)

2012-06-15

218

Traumatic (para)interhemispheric hematoma  

International Nuclear Information System (INIS)

One interhemispheric subdural hematoma and two parainterhemispheric intracerebral hematomas diagnosed with CT-scan (Hitachi) are reported. The clinical pictures and the mechanism of occurrence of hematoma in these particular regions are discussed. Because of the peculiar hematoma it is necessary to take CT-scan up to the vertex when monoparesis or hemiparesis of the leg, which is more prominent in the leg, are noticed after the head injury. Brain atrophy might be related to the occurrence of hematoma in these peculiar regions after the head injury. (author)

219

Subdural hygroma in association with middle fossa arachnoid cyst: acetazolamide therapy.  

Science.gov (United States)

Intracranial arachnoid cysts are cerebrospinal fluid-filled collections between arachnoid layers. While many are silent, arachnoid cysts can become symptomatic if there is sudden expansion, haemorrhage or rupture with the development of subdural hygroma or subdural hematoma. Several studies have demonstrated the association of arachnoid cysts with subdural hygroma and subdural hematoma. We describe a 9-year-old girl with a moderate-sized middle-fossa arachnoid cyst and bilateral frontal subdural hygroma presenting with raised intracranial pressure. She was treated with acetazolamide which resulted in resolution of the subdural hygroma and relief of symptomatology. PMID:9761002

Choong, C T; Lee, S H

1998-08-01

220

Clinical characteristics and risk factors of chronic subdural haematoma associated with clipping of unruptured cerebral aneurysms.  

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Chronic subdural haematoma (CSDH) is an uncommon but potentially serious complication of clipping unruptured cerebral aneurysms. We conducted a study to identify the patients who are at risk of developing postoperative CSDH. The data from 713 consecutive patients who underwent clipping of unruptured anterior circulation aneurysms were reviewed, and risk factors correlated with CSDH were identified by multivariate regression analysis of demographic variables. Fifteen patients (2.1%) developed CSDH after the surgery. Advanced age (odds ratio [OR] 1.151, 95% confidence interval [CI] 1.051-1.261) and male gender (OR 3.167, 95% CI 1.028-9.751) were correlated with CSDH. Subsequently, all 713 patients were quadrichotomized on the basis of gender and age, with 70 years as the cut-off value for age. The frequency of CSDH in men <70 years of age was 1.3% and that in men ?70 years of age was 15.1%, with risk of CSDH was significantly higher in the older men (OR 13.39; 95% CI: 3.42-52.44). The frequency of CSDH in women <70 years of age was 0.6% and that in women ?70 years of age was 3.7%. As in men, the risk of CSDH was significantly higher in the older women (OR 6.69, 95% CI 1.10-40.73). The interval between the aneurysm clipping and CSDH development was 0.5-6 months, suggesting that clinical observation should be continued up to 6 months after surgery. Although prognosis for patients with a postoperative CSDH complication is generally favourable, the risk of CSDH should be taken into account when considering elective clipping of unruptured aneurysms in patients ?70 years of age. PMID:23669172

Inamasu, Joji; Watabe, Takeya; Ganaha, Tsukasa; Yamada, Yasuhiro; Nakae, Shunsuke; Ohmi, Tatsuo; Imizu, Shuei; Kaito, Takafumi; Ito, Keisuke; Nishiyama, Yuya; Hayashi, Takuro; Sano, Hirotoshi; Kato, Yoko; Hirose, Yuichi

2013-08-01

221

Encapsulated subdural empyema  

International Nuclear Information System (INIS)

A case of encapsulated subdural empyema was reported. This 1.5-year-old boy was admitted with the increasing confusion and convulsion. Eight months prior to admission, he had craniotomy for traumatic acute epidural hematoma on the left side. Following a coagulation of the middle meningeal artery which was the bleeding source, the dura was opened but no cortical damage was noted at that time. The computed tomographic (CT) scan on admission revealed a large subdural collection with a thin enhancing rim on the left side. Emergency craniotomy revealed a collection of subdural pus, which was irrigated and a catheter was put for continuous drainage. Postoperatively, the patient did well, however, following removal of the catheter, three weeks after the first operation, the subdural empyema was reexpanded with a very thick enhancing rim on CT scan. Ultrasonography also clearly demonstrated the formation of the thick membranes. The large craniotomy was performed and empyema with the outer and inner memberanes of 8mm thick was totally excised. Post-operative CT scan did not show any enhancing rim, indicating that enchancement was caused by newly formed vessels within the membranes per se. This findings are totally different from those observed in the brain abscess in which ring enhancement on CT continues months to years following so-called extracapsular excision of abscess. In the brain abscess, surrounding glial tissue with plenty neovascularization is left intact, even afteovascularization is left intact, even after the operation. (author)

222

Abdominal chronic expanding hematoma causing iron-deficiency anemia in a dog.  

Science.gov (United States)

A 2 yr old spayed female mixed-breed Irish wolfhound was referred for assessment of anemia and slowly progressing abdominal distention. At the time of admission, the dog had marked anemia and thrombocytosis, a decreased serum iron concentration, and a normal coagulation profile. An ultrasound examination showed a massive fluid-filled cavitated structure in the abdominal cavity. Paracentesis of that structure yielded a large amount of hemorrhagic fluid with an iron concentration >24 times greater than the serum iron concentration, consistent with chronic sequestration of iron, leading to iron-deficiency anemia. Blood transfusions and incomplete surgical removal of the structure allowed short-term stabilization of the patient, but the dog was euthanized 17 days postsurgery for lethargy and continued abdominal distention. Histopathological evaluation of the structure was consistent with a chronic expanding hematoma. To the authors' knowledge, this is the first reported case of intra-abdominal chronic expanding hematoma in a dog. It is also unique given its features of iron-deficiency anemia caused by internal blood loss. PMID:25028435

Sebbag, Lionel; Harkin, Kenneth R; Habekost, Allison; Gumber, Sanjeev; Lee, Tiffany

2014-01-01

223

Chronic subdural haematomas: a comparative study of an enlarged single burr hole versus double burr hole drainage.  

Science.gov (United States)

Various surgical treatments have been proposed for the treatment of chronic subdural haematoma (CSDH). Herewith, we set out to compare the efficacy of an enlarged single burr hole versus double burr hole drainage for the treatment of CSDH. We studied patients with symptomatic CSDH proven by CT scan that were treated in our institute between January 2002 and January 2009. All patients were treated by an enlarged single or double burr hole drainage. A subdural drain was placed in all cases. A total of 245 patients were included in the study. Double hole drainage was performed in 156 (63.7%) patients (group A) and an enlarged single burr hole drainage in 89 (36.3%) patients (group B). There were nine recurrences in group A and five in group B; however, the difference was not statistically significant. There was no significant relationship between recurrence rate and age, gender, bilateral haematoma and antiplatelet or anticoagulant therapy. There was a trend towards higher risk of recurrence for patients with residual clots on postoperative CT scan. The mean hospitalization time was 6.2 days, and there was no significant difference between the two groups. No significant difference was found between patients' outcome, as assessed by Glasgow outcome scale score, and treatment method. Enlarged single burr hole and double burr hole drainage had the same efficacy in the treatment of CSDH. PMID:22869256

Pahatouridis, Dimitrios; Alexiou, George A; Fotakopoulos, George; Mihos, Evaggelos; Zigouris, Andreas; Drosos, Dimitrios; Voulgaris, Spyridon

2013-01-01

224

Subdural empyema, retropharyngeal and parapharyngeal space abscess: Unusual complications of chronic otitis media  

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Full Text Available Introduction. Otitic complications arise from expansion of the middle ear infection. Subdural empyema is a rare otitic complication, and both retropharyngeal and parapharyngeal abscesses have been described in just a few cases. Case report. A 30-year-old male was, admitted as an emergency case because of breathing difficulties, secretion from the ear, and fever. Clinical examination had shown a purulent, fetid secretion from the ear, swelling on the roof of epipharynx, left tonsil pushed medialy, immobile epiglottis, reduced breathing space. Computed tomography revealed thick hypodense content filling cavity, mastoid entering the posterior cranial fossa, descending down throw the parapharyngeal space to the mesopharynx. On the roof and posterior wall of the epipharynx hypodense collection was also present. Tracheotomy was conducted, and incision of the parapharyngeal and retropharyngeal abscess and radical tympanomastoidectomy were performed. The patient’s state deteriorated on the tenth postoperative day with hemiparesis and consciousness disorder. Magnetic resonance imaging was done. It showed subdural empyema of the left frontoparietal region and next to the falx, so craniotomy and abscess drainage were conducted. Conclusion. Parapharyngeal, retropharyngeal abscess and subdural empyema are rare otitic complications. Adequate antibiotic therapy and radical surgical treatment make possible an outcome with survival.

Erdevi?ki Ljiljana

2012-01-01

225

Non-traumatic spontaneous spinal subdural haematoma.  

Science.gov (United States)

We are presenting a case of non-traumatic spontaneous spinal subdural hematoma in a patient on warfarin and fluoxetine. This diagnosis should be considered early in patients who are on warfarin or fluoxetine or both presenting with acute neurological abnormalities of the limbs, and early decompression could result in good neurological outcome. PMID:23159904

Haji Mohd Yasin, Nur A B; Donato-Brown, Daniella; Taha, Ahmad

2012-10-12

226

Chronic lumbar epidural hematoma in a patient suffering with spondylolytic spondylolisthesis at the L4-5 level: a case report  

International Nuclear Information System (INIS)

Nontraumatic spinal epidural hematoma (SEH) is a rare condition and the exact cause of the hemorrhage in SEH had never been established. However, there have been a few recent reports on some types of the epidural hematoma with a detectable origin of hemorrhage. We encountered a case of chronic SEH in a patient who had spondylolytic spondylolisthesis, which is also a rare condition to be associated with SEH. We report here on the radiologic findings of a case of chronic epidural hematoma in a patient who had spondylolytic spondylolisthesis at the L4-5 level, and we include a review of the related literatures

227

The repeat CT-findings of the contusional hematoma  

International Nuclear Information System (INIS)

Twenty-seven cases of traumatic intracerebral hematoma were treated from 1977 to 1979. The intracerebral hematomas are classified into three groups: central type, hematoma within contusional area and contusional hematoma, according to the CT findings and the clinical course. Fourteen of these cases are diagnosed as contusional hematoma which show a normal CT scan, subarachnoidal hemorrhage, subdural hematoma and epidural hematoma without any kind of intracerebral high density in the initial CT scan performed within 6 hours after injury. Ten of the cases were found during conservative treatment; in 2 cases, hematomas were revealed within 24 hours; in 2 more cases within 48 hours, and in 6 cases, within 3 - 5 days following injury. In the other 4 cases, hematoma occurred 1 - 2 days following the emergency evacuation of a subdural hematoma and decompressive craniectomy. Based on the clinical experience outlined above, it is our current practice in diagnosing patients with contusional hematoma to perform repeat CT scanning within 5 - 6 days after injury whenever isodensity or subarachnoidal hemorrhage with a shift in the midline structure is observed in an initial CT scan within 6 hours or whenever an evacuation of the subdural hematoma with decompressive craniectomy is performed. (author)

228

Diagnosis and follow-up studies of traumatic subdural fluid collection  

International Nuclear Information System (INIS)

A considerable amount of research has been reported on subdural fluid collection after head trauma since the first case was reported by Dandy in 1912. This research was conducted by means of cerebral angiography, pneumoencephalographic study, and other neurological methods. However, Computed Tomography (CT scan) has become a great new means of neurological diagnosis, especially in the localization of the intracranial mass, and there exists a considerable amount of literature on intracranial disease. Nevertheless, little work has been done in studying the traumatic subdural fluid collection of adults by CT scan. Six cases of this disease in adults have now been analyzed by CT scan. The following results were obtained. (1) It is possible to diagnose traumatic subdural fluid collection using the CT scan alone and to differentiate this disease from brain atrophy and chronic subdural hematoma of the low-density type. (2) The CT scan findings are as follows. The location in all cases is on the bi-frontal tip, the figure is eccentric and symmetrical, and the Hounsfield unit shows 7. There is no relation between the location and the site of the hit. There is no intracranial mass sign. (3) After surgical therapy by the trephine method, the findings of CT scan and the neurological deficits normalized remarkably within 14 days in our cases. (author)

229

The CT examination of changes in intracranial hematoma density  

International Nuclear Information System (INIS)

The study was undertaken to assess the changes in the size and densities of intracranial hematoma by analyzing the sequential CT examination of 23 patients at Soonchunhyang College Hospital from Jul. 1980 to Aug. 1981. The results were as follows; 1. The right densities of hematoma were reduced slowly in size and density. 2. The factors influence the rate of changes were the cause of hematoma, hematoma location, age and sex of patient, and initial hematoma size. 3. The CT findings that indicate complete absorption of hematomas were normalization of mass effect, not disappearance of hematoma densities. 4. In intracerebral hematoma, the high density of hematoma reduced it's density and mass effect about 4-6 weeks duration. 5. In subdural hematoma, about 7 weeks after head trauma, the CT findings were normalized

230

Microwave hematoma detector  

Science.gov (United States)

The Microwave Hematoma Detector is a non-invasive device designed to detect and localize blood pooling and clots near the outer surface of the body. While being geared towards finding sub-dural and epi-dural hematomas, the device can be used to detect blood pooling anywhere near the surface of the body. Modified versions of the device can also detect pneumothorax, organ hemorrhage, atherosclerotic plaque in the carotid arteries, evaluate perfusion (blood flow) at or near the body surface, body tissue damage at or near the surface (especially for burn assessment) and be used in a number of NDE applications. The device is based on low power pulsed microwave technology combined with a specialized antenna, signal processing/recognition algorithms and a disposable cap worn by the patient which will facilitate accurate mapping of the brain and proper function of the instrument. The invention may be used for rapid, non-invasive detection of sub-dural or epi-dural hematoma in human or animal patients, detection of hemorrhage within approximately 5 cm of the outer surface anywhere on a patient's body.

Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA); Matthews, Dennis L. (Moss Beach, CA)

2001-01-01

231

Hematoma and MR imaging at 0.15 T. A review of 100 cases  

International Nuclear Information System (INIS)

One hundred hematomas were examined by magnetic resonance imaging (MRI) at 0.15 T, all explored in SEpT1 and most in SEpT2. The number of cases examined in the acute phase during the first 48 hours was low: 8 cases. At this SEpT1 period the hematoma appears of elevated signal with good muscle contrast but without contrast in hepatic and cerebral parenchyma. In a weighted T2 sequence, the intense signals of cerebral edema and plasma or serum enables detection of the encephalic lesion. Findings from 68 hematomas observed in the subacute or chronic phase suggest that their appearance is pathognomonic with visualization in SEpT1 of a crown of an intense signal at least equal to that of fat. The only difficulty at this period is the discovery of a hematoma within the fat: orbital, retroperitoneal... The collection of a subdural hematoma usually appears homogeneous, the intensity of the signal varying with red cell concentration and time. In the soft tissues, the intensity of signal is a function of concentration of hemoglobin and its derivatives and of volume of serious effusion. Images of 24 hematomas during the sequelae phase confirmed the appearance of a ''biochemical shell'' without signal in SEpT2 and allowed detection of the hematic contents of an occupying process even after long periods, sometimes after one year

232

Hematoma and MR imaging at 0. 15 T. A review of 100 cases  

Energy Technology Data Exchange (ETDEWEB)

One hundred hematomas were examined by magnetic resonance imaging (MRI) at 0.15 T, all explored in SEpT/sub 1/ and most in SEpT/sub 2/. The number of cases examined in the acute phase during the first 48 hours was low: 8 cases. At this SEpT/sub 1/ period the hematoma appears of elevated signal with good muscle contrast but without contrast in hepatic and cerebral parenchyma. In a weighted T/sub 2/ sequence, the intense signals of cerebral edema and plasma or serum enables detection of the encephalic lesion. Findings from 68 hematomas observed in the subacute or chronic phase suggest that their appearance is pathognomonic with visualization in SEpT/sub 1/ of a crown of an intense signal at least equal to that of fat. The only difficulty at this period is the discovery of a hematoma within the fat: orbital, retroperitoneal... The collection of a subdural hematoma usually appears homogeneous, the intensity of the signal varying with red cell concentration and time. In the soft tissues, the intensity of signal is a function of concentration of hemoglobin and its derivatives and of volume of serious effusion. Images of 24 hematomas during the sequelae phase confirmed the appearance of a ''biochemical shell'' without signal in SEpT/sub 2/ and allowed detection of the hematic contents of an occupying process even after long periods, sometimes after one year.

Cosnard, G.; Jeanbourquin, D.; Blanc, A.M.; Perfettini, C.; Iba Zizen, M.T.; Cabanis, E.A.

1987-05-01

233

Subdural empyema in chronic suppurative otitis media: a rarely encountered complication  

OpenAIRE

Here the authors describe the case of a 23-year-old young woman with life-threatening focal suppurative intracranial collection with brain compression secondary to long forgotten chronic suppurative otitis media. With the development and availability of broad-spectrum antibiotics and their timely usage, cases of suppurative otitis media are a rarity in the current times.

Gupta, Monica; Singh, Kamal; Lehl, S. S.

2011-01-01

234

Subungual Hematoma  

Science.gov (United States)

... Name: Category: Share: Yes No, Keep Private Subungual Hematoma Share | A subungual hematoma is a transient condition where blood and fluid ... area works best. Compression can further reduce the bleeding underneath the nail. Regardless of treatment the hematoma ...

235

Subdural haemorrhage following endoscopic third ventriculostomy. A rare complication.  

LENUS (Irish Health Repository)

Subdural collections or hematomas are frequently observed after shunt placement [7-9, 13], but rarely after ETV [6]. A review of literature revealed 7 cases [1, 5, 6, 10, 12], of which only 1 was symptomatic [5]. We will discuss the causes, management, and methods of prevention of this complication and we will present a case of symptomatic subdural haematoma, following endoscopic third ventriculostomy for illustration.

Kamel, M H

2012-02-03

236

Hematoma espinal / Spinal hematoma  

Scientific Electronic Library Online (English)

Full Text Available El hematoma epidural espinal es un hallazgo poco frecuente en la práctica médica. Se presenta un caso de una paciente portadora en la región dorsal, donde su forma de presentación también se consideró muy inhabitual y confusa; esta debutó con un dolor precordial con irradiación del brazo izquierdo, [...] la espalda y el estómago, instaurándose después una mielitis transversa dorsal. Se presenta el resultado de la resonancia magnética nuclear dorsal, con consideraciones diagnósticas de los diferentes tipos de hematomas espinales. Se realizó una laminectomía desde D3 a D6 y se evacuó un extenso hematoma epidural desde D1 a D8. Abstract in english Epidural spinal hematoma is an infrequent finding in medical practice. A case of a female patient suffering from a pain in the dorsal region, with its way of presentation was also considered as an unusual and confuse occurrence; it started with precordial pain irradiating left arm, back and stomach, [...] establishing a dorsal transverse myelitis. The result of a nuclear magnetic resonance is presented with diagnostic considerations of different types of spinal hematomas. A laminectomy from D3 to D6 was performed and a large epidural hematoma from D1 to D8 was evacuated.

Antonio Javier, García Medina; Grecia María, Giniebra Marín; Juan Carlos, Bermejo Sánchez.

2013-04-01

237

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma  

OpenAIRE

Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performe...

Han, Sung Hoon; Lee, Ho Kook; Moon, Jae Gon; Kim, Chang Hyun; Cho, Tack Geun

2012-01-01

238

Suprarrenal hematoma Hematoma suprarrenal  

Directory of Open Access Journals (Sweden)

Full Text Available Neonatal asymptomatic suprarrenal hemorrhage is relatively frequent; sometimes it is detected only after resolution when a calcification is found; symptomatic forms are rare; most times hemorrhage and hematoma are due to an obstetric trauma and are related to macrosomia, breech presentation, maternal diabetes and neonatal hypoxia. Clinical picture is characterized by abdominal mass and anemia; diagnosis is confirmed by imagenology. Two patients with suprarrenal hematoma from the University Hospital at Cartagena, Colombia, are presented. Both were related with traumatic delivery and cephalohematoma; one of them had oral and gastric bleeding and the othersuffered hematoma infection; diagnosis was done with abdominal ecography and CAT. Both patients recovered with medical treatment. La hemorragia suprarrenal asintomática del neonato es relativamente frecuente y muchas veces se detecta como una calcificación local después de que se resuelve el hematoma. La forma sintomática es rara y, a menudo, se debe a un trauma obstétrico relacionado con la macrosomía fetal, la presentación podálica, la diabetes materna o la hipoxia perinatal. Las manifestaciones clínicas son, principalmente, una masa abdominal y anemia importante; el diagnóstico se confirma con la imaginología. Se presentan dos casos de hematoma suprarrenal derecho tratados en el Hospital Universitario de Cartagena, ambos relacionados con un parto traumático y acompañados de cefalohematomas; uno de ellos presentó sangrado gastrointestinal alto y el otro infección del hematoma suprarrenal. El diagnóstico se comprobó con la ecografía abdominal y se verificó con la tomografía. El tratamiento fue médico y no se requirió cirugía a pesar de la anemia severa que presentó uno de los pacientes.

Concepción Guardo B.

1996-04-01

239

Spinal epidural hematomas examined on MRI  

International Nuclear Information System (INIS)

Spinal epidural hematomas are rare pathology, caused by trauma or spontaneous. In clinical examination acute spinal cord compression is observed. MRI designations appear entirely particular. In sagittal projection, biconvex mass in the dorsal, or sometimes ventral part of the spinal canal is clearly visible. This is well delineated by the thecal sac from the cord and cauda equina. MRI investigations in 3 patients revealed corresponding with spinal bone injuries and cord edema epidural hematomas. Differential diagnosis must contain subdural hematoma and epidural neoplasms or abscess. (author)

240

Percutaneous drainage of a postoperative intraspinal hematoma using a Tuohy needle  

International Nuclear Information System (INIS)

A 78-year-old man developed a large subdural hematoma extending from T12 to L3 levels following L3 laminectomy and L3-5 posterior spinal fusion. He had associated neurological signs and symptoms. MR imaging showed typical signal characteristics of a subacute intraspinal subdural hematoma. Percutaneous drainage was successfully performed under CT guidance by inserting a Tuohy needle through the L3 laminectomy defect. The catheter packaged with the Tuohy needle was inserted cranially into the hematoma and 30 ml of blood was aspirated. Follow-up MR imaging confirmed resolution of the hematoma and the patient made a rapid recovery. (orig.)

241

Subdural abscess in infant and child  

International Nuclear Information System (INIS)

Two cases of subdural abscess in infant and child treated with irrigation via burr holes were reported. The first case was a 1.4-year-old boy with right hemiparesis and mental retardation since severe head trauma at 9 months old. The patient with manifested with an acute onset of high fever followed by disturbance of consciousness and convulsive seizures 2.5 months prior to admission to our department. During admission in the other hospital, the diagnosis of septicemia caused by E. coli was made by blood cultures when CT scan demonstrated a huge lentiform low density area over the right hemisphere and contralateral crescent low density area. The low density area on the right side was well circumscribed by high density rim which was enhanced by contrast medium. Under the diagnosis of bilateral subdural abscess secondary to septicemia caused by E. coli, irrigation of the purulent cavity was carried out. The contralateral low density area was found to be chronic subdural effusion. The second case of 3-month-old infant who complained of high fever, neck stiffness, unconsciousness and right hemiconvulsions 8 days prior to admission. CT scan showed bilateral crescent low density areas indicating subdural effusion. Subdural punctures performed via the fontanelle revealed pus in the left subdural space and xanthocromic fluid in the right side. The low density area on CT scan was changed to the lentiform high density area circumscribed smooth high density rim during the course smooth high density rim during the course of the patient. The subdural abscess was treated with irrigation via burr holes. In this report, the etiology of the subdural abscess and route of infection in addition to follow up study of CT findings were presented with the literature. (author)

242

[Kernohan-Woltman notch phenomenon secondary to a cranial epidural hematoma].  

Science.gov (United States)

Kernohan-Woltman notch phenomenon is a paradoxical neurological manifestation which involves a motor deficit on the same side as the primary brain injury. It is produced mainly by acute or chronic subdural hematomas, and less frequently by post-traumatic epidural ones. It should be taken into consideration in cases of ipsilateral motor deficit, as it may lead to surgical procedures being performed on the incorrect side. We report the case of a 40 year old man who sustained a major head injury which was followed by a decreased level of consciousness and anisocoria. Computed tomography of the brain revealed a frontal and parietal epidural hematoma with right midline shift and uncal herniation. Craniotomy and drainage of the hematoma was performed, and on the sixth day after surgery it was observed that the patient had a brachio-crural right hemiparesis. Magnetic resonance imaging showed an ischemic area on the left capsule and cerebral peduncle consistent with the diagnosis of Kernohan-Woltman notch phenomenon. PMID:23809681

Mejía Kattah, J; Vilá Barriuso, E; García Bernedo, C; Gallart Gallego, L

2014-01-01

243

Retropharyngeal hematoma.  

OpenAIRE

ABSTRACT Retropharyngeal hematomas (RPH) are relatively rare. They are clinically important because of the close proximity to the upper airway, which can be life threatening and requires immediate intervention. We report one patient who presented with RPH due to anticoagulation that resulted in airway obstruction and subsequent intubations. We outline the normal anatomy of the retropharyngeal space, the pathogenesis and treatment of RPH, with related literature review.

Alherabi, Ameen Z.

2008-01-01

244

Aneurysmal acute subdural hemorrhage: prognostic factors associated with treatment.  

Science.gov (United States)

Acute subdural hematoma is an uncommon presentation of aneurysmal hemorrhage that has been identified as a poor prognostic sign. Current series are small, have short follow-up, or were collected over a long period during which treatment evolved. To evaluate prognostic factors, we analyzed a large modern series of aneurysmal subdural hematoma (aSDH) with long-term follow-up. A prospectively maintained database was queried for patients presenting with aSDH from 2001-2013. Thirty patients met the study criteria. Statistical analysis was performed with unpaired t-test or Fisher's exact test. Aneurysm treatment involved open clipping (n=18), endosaccular coiling (n=8), both (n=1), or no treatment (n=3). Good Glasgow Outcome Scale score at discharge was present in 20% and increased to 40% at 6-12 months postoperatively. Good clinical presentation was associated with good final outcome in 75%, whereas poor clinical presentation correlated with good outcome in 30%. Good outcome correlated with younger age (p=0.04), smaller aneurysm (p=0.04), and lower Hunt-Hess score (HH) at intervention (p=0.04). Favorable outcome did not correlate with sex, race, presence of subarachnoid or intraparenchymal hemorrhage, size or laterality of hemorrhage, midline shift, aneurysm treatment modality, or HH at admission (p>0.15). There was no difference between good and poor outcomes in terms of time to treatment or hematoma evacuation. Poor clinical presentation may be exaggerated by mass effect of hematoma; aggressive treatment is not futile. Presenting neurological status, age, and aneurysm size are predictors of outcome, while laterality and size of hematoma and extent of midline shift are not, suggesting that clinical status is more important than radiographic findings. PMID:24679648

Kulwin, Charles; Bohnstedt, Bradley N; Payner, Troy D; Leipzig, Thomas J; Scott, John A; DeNardo, Andrew J; Cohen-Gadol, Aaron A

2014-08-01

245

Idiopathic Hypertrophic Cranial Pachymeningitis Misdiagnosed as Acute Subtentorial Hematoma  

OpenAIRE

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. Dur...

Park, Ik-seong; Kim, Hoon; Chung, Eun Yong; Cho, Kwang Wook

2010-01-01

246

Dabigatran-associated subdural hemorrhage: using thromboelastography (TEG(®)) to guide decision-making.  

Science.gov (United States)

Novel oral anticoagulants present challenges and uncertainties in the management of hemorrhagic emergencies. An 84-year-old man taking dabigatran presented with a subdural hematoma requiring neurosurgical intervention. Routine coagulation assays were prolonged at admission and following administration of Factor VIII Inhibitor Bypassing Activity (FEIBA). Thromboelastography (TEG(®)) was utilized to assess clot dynamics prior to placement of a subdural drain, which was safely inserted despite a prolonged thrombin time (TT). Exclusive reliance on the TT may delay necessary interventions. TEG(®) may be a valuable tool to investigate hemostasis in patients on dabigatran requiring emergent procedures. PMID:23666496

Neyens, Ron; Bohm, Nicole; Cearley, Madelyne; Andrews, Charles; Chalela, Julio

2014-01-01

247

Subdural Empyema in Children  

Directory of Open Access Journals (Sweden)

Full Text Available Subdural Empyema in infants and children might be life threatening if not managed properly. A search of the Pub Med database was carried out using a combination of the following terms: Subdural empyema, children, and management. Neurosurgical textbooks were reviewed as well. The prevalence, etiology, clinical features, investigations and management of SDE are reviewed in this article. Conservative management with antibiotics and follow up imaging is recommended if there are no focal deficits, change in mental status or if the patient is responding well to antibiotics. Alternatively, craniotomy is warranted in addition to antibiotics therapy. The surgeon might opt for burr holes in case the patient is frail or in septic shock.

Mohammed A. Hendaus

2013-07-01

248

Extracerebral hematoma and parenchymal lesion in computerized tomography of pediatric patients with severe head injury  

International Nuclear Information System (INIS)

Fifty children (13 years of age or under) with acute, severe head injury were analyzed, with special reference to the relations between initial computerized tomography (CT) findings, clinical severity, and outcome. The severity and the outcome were evaluated using the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS), respectively, adoption of GCS scoring being restricted to patients 3 years of age or over. Twenty-three patients (46 %) showed extracerebral hematomas. The most common extracerebral hematoma was the acute subdural hematoma, which comprised 24 % of the cases; epidural hematomas were found in 9 cases (18 %). These figures coincided with the reported results of adult cases in severe head injury. All the epidural hematoma cases showed ''normal'' parenchymal lesion, and carried less clinical severity and better outcome. This might suggest that more trivial injury would cause the epidural hematoma in children than in adults. Hemispheric swelling was commonly seen in patients with acute subdural hematoma and was generally associated with low GCS scores (mean 4.8) and poor outcome (63 % mortality). Compared with that in adults, hemorrhagic lesion in children was less often associated with extracerebral hematoma, and the outcome and severity of the cases with this lesion depended mainly on the multiplicity and the location of the hemorrhage. Eleven cases fulfilled the criteria of diffuse cerebral swelling, namely, slit-like ventricles and obliterated perimesencephalic cisterns, and only one had an associated subdural hematoma. Forty-two patients (84 %) achieved a good recovery or a moderate disability. None were severely disabled or vegetative, and the overall mortality rate was 16 %. Patients with GCS scores of 3 to 5 were uniformly poor in outcome (60 % of mortality), regardless of parenchymal lesions, whereas those with GCS scores of 6 to 8 had only 8 % mortality. (J.P.N.)

249

Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.

Hagino Tetsuo

2012-03-01

250

Epidural hematomas of posterior fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

Radulovi? Danilo

2004-01-01

251

A Knowledge Discovery Approach to Diagnosing Intracranial Hematomas on Brain CT: Recognition, Measurement and Classification  

Science.gov (United States)

Computed tomography (CT) of the brain is preferred study on neurological emergencies. Physicians use CT to diagnose various types of intracranial hematomas, including epidural, subdural and intracerebral hematomas according to their locations and shapes. We propose a novel method that can automatically diagnose intracranial hematomas by combining machine vision and knowledge discovery techniques. The skull on the CT slice is located and the depth of each intracranial pixel is labeled. After normalization of the pixel intensities by their depth, the hyperdense area of intracranial hematoma is segmented with multi-resolution thresholding and region-growing. We then apply C4.5 algorithm to construct a decision tree using the features of the segmented hematoma and the diagnoses made by physicians. The algorithm was evaluated on 48 pathological images treated in a single institute. The two discovered rules closely resemble those used by human experts, and are able to make correct diagnoses in all cases.

Liao, Chun-Chih; Xiao, Furen; Wong, Jau-Min; Chiang, I.-Jen

252

Acute subdural empyema  

International Nuclear Information System (INIS)

The patient, a 19-year-old male, began suffering from severe headache, vomiting, and high fever. Two days later the patient was admitted in a semicomatose state and with left hemiplegia. Nuchal rigidity and choked disc were not noticed. WBC count was 12,500/mm3. CT scan disclosed marked swelling of the right cerebral hemisphere with midline shift. Except for a small lucent space in the parafalcial region, no extracerebral collection was noted in either pre- or post-contrast scans. Plain craniograms showed clouding of the left frontal, ethmoidal, and sphenoidal sinuses. Carotid angiography revealed prolongation of the circulation time and stenosis of the supraclinoidal portion of the right carotid artery. Right fronto-parietal decompressive craniectomy was performed. Subdural empyema was found and evacuated. Curettage and drainage of the empyema in the paranasal sinuses were also done. A bone defect 4 mm in diameter was detected on the medial-upper wall of the left frontal sinus. The causative organism was confirmed as ?-Streptococcus. Both systemic and local antibiotics were administered and the patient recovered well and was discharged without any neurological deficit. The authors emphasized that cerebral angiography is necessary for its accurate diagnosis of subdural empyema in its acute stage and that emergency intracranial and rhino-otological operations should be concomitantly performed. (author)

253

Spontaneous Spinal Epidural Hematoma  

OpenAIRE

Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but significant spinal condition. Urgent surgical evacuation of a hematoma is generally indicated to prevent serious permanent neurological deficits. We encountered three cases of spontaneous spinal epidural hematomas associated with motor weakness that were treated successfully by surgical intervention.

Baek, Byung Suck; Hur, Jin Woo; Kwon, Ki Young; Lee, Hyun Koo

2008-01-01

254

Craneotomía limitada para el tratamiento de los hematomas traumáticos agudos en el adulto mayor / Limited craniotomy as treatment of acute traumatic hematoma in the elderly  

Scientific Electronic Library Online (English)

Full Text Available Fundamento: el tratamiento quirúrgico de los hematomas yuxtadurales traumáticos en el adulto mayor es un tema complejo y controversial por la elevada mortalidad que lo acompaña. Objetivo: presentar los resultados preliminares de la aplicación de la craneotomía limitada para la evacuación de los hema [...] tomas yuxtadurales traumáticos agudos en el adulto mayor. Método: estudio descriptivo de los resultados del tratamiento quirúrgico de los hematomas yuxtadurales traumáticos agudos en 19 pacientes con 60 años y más, atendidos por el Servicio de Neurocirugía del Hospital Universitario Manuel Ascunce Domenech, en el período de enero de 2008 a diciembre de 2010. Resultados: en 17 pacientes la Tomografía Axial Computarizada de cráneo mostró la presencia de hematomas subdurales agudos hemisféricos. El 58.8 % de los pacientes con hematoma subdural agudo y el 100 % con hematomas intracerebrales fallecieron. Se realizaron 18 craneotomías limitadas, logró sobrevivir el 39 % de los pacientes. Conclusiones: la realización de la craneotomía limitada para la evacuación de este tipo de lesiones primarias, en esta serie, mostró resultados alentadores, poco menos de la mitad de los pacientes lograron sobrevivir con buen pronóstico por lo que se considera es una opción terapéutica a tener en cuenta pendiente de evaluar sus resultados en futuras investigaciones. Abstract in english The surgical treatment of traumatic hematomas in the elderly is a complex and controversial topic due to its associated high mortality rate. Objective: the purpose of this article is to present the preliminary findings on the use of limited craniotomy for the evacuation acute juxtadural traumatic he [...] matomas in the elderly. Method: a descriptive study on the surgical treatment results of acute juxtadural traumatic hematomas was conducted involving 19 elderly patients of 60 years and over treated in the Neurosurgical service at the University Hospital “Manuel Ascunce Domenech” from January 2008 to December 2010. Results: CAT scan results revealed the presence of acute hemispheric subdural hematomas in 17 patients. The 58,8 % of patients diagnosed with acute subdural hematoma as well as the 100 % of those with intracerebral hematomas died. Eighteen limited craniotomies were performed with a 39 % survival rate. Conclusion: this research reveals promising preliminary results for limited craniotomy as the treatment of choice for these primary lesions, owing to the fact that close to 40 % of patients who had this treatment survived with good prognosis what is considered as a therapeutic option pending to assess its results in future research.

Gretel, Mosquera Betancourt; Ariel, Varela Hernández; Denis, Suárez Monné; Yanmara, Bethartes Sotomayor.

2011-10-01

255

Fatal Subdural Empyema Following Pyogenic Meningitis  

OpenAIRE

Subdural empyema is a rare form of intracranial sepsis associated with high morbidity and mortality. The most frequent cause is extension of paranasal sinusitis through emissary veins or of mastoiditis through the mucosa, bone, and dura mater. Development of subdural empyema after pyogenic meningitis is known to be very unusual in adults. We report a rare case of fatal subdural empyema, an unusual complication of pyogenic meningitis. Our bitter experience suggests that subdural empyema should...

Lee, Seok Ki; Kim, Seok Won

2011-01-01

256

Acute aggravation of subdural fluid collection associated with dural metastasis of malignant neoplasms: case report and review of the literature.  

Science.gov (United States)

A 63-year-old woman was admitted to our hospital with serious headache and vomiting. Five months before admission, she had undergone surgery for a primary advanced gastric cancer. Neuroradiological examinations revealed subdural fluid collection. We twice performed evacuation of the subdural fluid collection. However, aggravation of her state of consciousness progressed and she passed away. Histological examinations demonstrated that the dural veins were infiltrated by numerous tumor cells that produced mucus; however, ruptured vessels were not found. Furthermore, the subdural fluid collection increased shortly after the initial operation. We infer that the cause of the collection, which was associated with the dural metastasis of malignant tumors, was not only mucin secretion by tumor cells but also a rapid increase in perfusion pressure in the vessels of the dura mater, resulting in extravasation of plasma components into the subdural space. Our case demonstrates that the pathogenetic mechanism that is specific for subdural fluid collection caused by dural metastasis of malignant tumors differs from the mechanism of production of subdural hematoma associated with dural metastasis. PMID:24036578

Kimura, Shigeyoshi; Kotani, Akio; Takimoto, Toshiro; Yoshino, Atsuo; Katayama, Yoichi

2014-10-01

257

Bilateral assymetric epidural hematoma  

Science.gov (United States)

Background: Acute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5–10% of all extradural hematomas. However, higher mortality rates have been reported in previous series. Case Description: The authors described the case of a 28-year-old male presenting head injury, comatose, Glasgow Coma Scale of 6, anisocoric pupils without puppilary light reflex. Computed tomography showed asymmetric bilateral epidural hematomas, effacement of the lateral ventricles and sulci, midline shift and a bilateral skull fracture reaching the vertex. Surgical evacuation was performed with simultaneous hematoma drainage. Patient was discharged on the 29th postoperative day with no neurological deficit. Conclusion: The correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage. PMID:25657867

Pereira, Edmundo Luis Rodrigues; Rodrigues, Daniella Brito; Lima, Lorena Oliveira; Sawada, Luis Armando; Hermes, Mário de Nazareth

2015-01-01

258

Spinal epidural hematoma  

International Nuclear Information System (INIS)

Spinal epidural hematoma is an accumulation of blood in the potential space between the dura and bone. On unenhanced computed tomography epidural hemorrhage appears as a high-density spinal canal mass with variable cord compression. Magnetic resonance imaging is the modality of choice for evaluating spinal epidural hematoma and can demonstrate the extent of the hematoma and degree of cord compression. When treated surgically the outcome depends on the extent of preoperative neurological deficits and on the operative timing interval. (orig.)

259

Hematoma traumático del psoas  

Scientific Electronic Library Online (English)

Full Text Available Los hematomas del psoas se suelen observar en pacientes con hemofilia u otras discrasias sanguíneas y como complicación de tratamientos anticoagulantes. Con menor frecuencia se pueden ver en personas sanas, debido a la rotura traumática del músculo. Por similares causas se producen hematomas del mús [...] culo ilíaco. La parálisis del nervio femoral es la complicación más grave y frecuente de ambas afecciones. Es habitual denominar a estos cuadros como hematomas del iliopsoas y considerarlos en conjunto por las características anatómicas, etiológicas, patológicas y clínicas que presentan. Describimos el caso de un niño de 12 años y 8 meses de edad, sin coagulopatía conocida, que padeció un hematoma del psoas de origen traumático. Abstract in english Psoas hematomas are usually seen in patients with hemophilia or other blood dyscrasias, and as a complication of anticoagulant treatments. With less frequency they may be found in healthy persons as a result of traumatic muscle rupture. Similar causes produce hematomas in the iliac muscle. The paral [...] ysis of the femoral nerve is the most serious and frequent complication in both conditions. These clinical pictures are often referred to as iliopsoas hematoma and they are generally considered together owing to the anatomic, etiologic, pathologic and clinical features that present. We describe a boy of 12 years and 8 month old, with no coagulopathy, who suffered a psoas hematoma of traumatic origin.

Roberto, Rocco; Laura, Benedetti; Cecilia, Pannocchia; Horacio, Miscione.

2006-12-01

260

Acute bilateral extradural hematomas.  

Directory of Open Access Journals (Sweden)

Full Text Available The occurrence of bilateral extradural hematomas is an uncommon consequence of craniocerebral trauma and its incidence is variable in various studies ranging from 2-25%.1 We studied all cases of head injury brought to our institute over a period of 6 months and found the incidence of bilateral extradural hematomas to be 13.3%.

Ramzan A

2002-04-01

261

Nasal septal hematoma  

Science.gov (United States)

A nasal septal hematoma is collection of blood within the septum of the nose. The septum is the part of the nose between ... A septal hematoma can be caused by: A broken nose Injury to the soft tissue of the area Surgery The problem ...

262

Iliacus hematoma syndrome.  

Science.gov (United States)

In a patient receiving warfarin and heparin in the treatment of pulmonary embolism, a hematoma developed in the iliacus muscle, compressing the overlying femoral nerve. Femoral nerve paralysis ensued, causing inability to walk, pain and loss of sensation in the sensory distribution of the nerve. Surgical intervention and removal of the hematoma relieved the nerve compression and the condition gradually improved. PMID:1122461

Kounis, N. G.; Macauley, M. B.; Ghorbal, M. S.

1975-01-01

263

Clinical features and management of posttraumatic subperiosteal hematoma of the orbit  

Directory of Open Access Journals (Sweden)

Full Text Available Traumatic subperiosteal hematoma (SpH usually presents late, after the initial trauma. It is generally seen in young males. Computed tomography is the best mode of imaging and helps to rule out orbital fracture or associated subdural hematoma. We present the clinical features and management of four patients seen at the orbit clinic with SpH. Management is based on time of presentation, visual acuity and any communicating bleed. The prognosis of traumatic SpH is excellent if treated with an individualized patient approach.

Kim Usha

2011-01-01

264

Clinical features and management of posttraumatic subperiosteal hematoma of the orbit  

OpenAIRE

Traumatic subperiosteal hematoma (SpH) usually presents late, after the initial trauma. It is generally seen in young males. Computed tomography is the best mode of imaging and helps to rule out orbital fracture or associated subdural hematoma. We present the clinical features and management of four patients seen at the orbit clinic with SpH. Management is based on time of presentation, visual acuity and any communicating bleed. The prognosis of traumatic SpH is excellent if treated with an i...

Kim Usha; Arora Vipul; Shah Akash; Solanki Urvashi

2011-01-01

265

Posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)

266

Giant acute epidural hematoma after ventriculoperitoneal shunt: a case report and literature review  

OpenAIRE

Cerebrospinal fluid over-drainage is a common complication of ventriculoperitoneal devices. In terms of haemorrhage, subdural haematomas are usually more frequent lesions than epidural hematomas, which, more rarely, may also be seen after ventricular shunt procedures and may lead to rapid neurological decline and even death unless a surgical procedure can be promptly performed. This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosi...

Noleto, Gustavo; Neville, Iuri Santana; Tavares, Wagner Malago?; Saad, Felippe; Pinto, Fernando Campos; Teixeira, Manoel Jacobsen; Paiva, Wellingson Silva

2014-01-01

267

Epidural hematoma confirmed by contrast enhancement in computed tomography  

International Nuclear Information System (INIS)

Four cases of chronic epidural hematomas confirmed only by contrast enhancement are presented. In two cases, hematomas were found in the posterior fossa, in one, in both supra- and infratentorial regions, and in the remaining one, in the supratentorial region. Noncontrast CT failed to show the biconvex high-density area typical of an acute epidural hematoma. One supratentorial and two posterior fossa hematomas were definitely diagnosed only after an injection of the contrast medium. In the remaining one with combined supra- and infratentorial hematomas, a hematoma in the right occipital region was diagnosed on plain CT alone, but the left supratentorial lesion was confirmed only after the injection of an iodinated contrast medium. The mechanisms responsible for the enhancement of the margin of the chronic epidural hematoma are discussed. The dura mater in close contract with the inner table of the skull is usually not seen on the enhanced CT. The falx and tentorium are ordinarily well enhanced, however, and in patients who have undergone bone-flap removal, the dura mater without any juxtaposed skull is enhanced. It may be supposed that the enhanced margin as seen in chronic epidural hematoma represents either the enhanced dura mater displaced from the inner table of the skull, with or without overlying granulation tissue, or the compressed and congested brain underneath the hematoma, or both. An extravasation of the iodine from the immature neovasculature of the granum the immature neovasculature of the granulation tissue may prove to play an important role. The importance of the contrast enhancement in CT scanning of selected patients in chronic stage after the head injury is stressed. (author)

268

Subacute epidural hematoma  

International Nuclear Information System (INIS)

This is the case of a patient presenting with right temporoparietal subacute hematoma secondary to a physical act of aggression. In clinical picture at 24 hours there was predominance of headache of moderate intensity with drowsiness and slight psychomotor restlessness. The skull single radiographies didn't show alterations. Symptoms remained despite the medical treatment, thus a single skull axial tomography was carried out showing the presence of a right temporoparietal subacute epidural hematoma with displacement from the middle line structures. A right temporoparietal craniotomy was carried out to evacuation of the posterior hematoma. Patient evolved satisfactorily with a total recovery as much clinical as imaging. (author)

269

SPONTANEOUS MESENTERIC HEMATOMA  

Directory of Open Access Journals (Sweden)

Full Text Available Spontaneous small bowel mesentery or retroperitoneal hematomas are rare pathology occurring in absence of any trauma, anticoagulant therapy, vessel’s anomaly or systemic inflammatory disease. We present a case of a 23-year old male patient diagnosed with small bowel mesentery hematoma that corresponds to the „spontaneous” definition, who was admitted three days after onset accusing pain and a tumorous mass in the mesogastric region. Abdominal US and CT revealed a high density tumorous mass with well defined borders and nonhomogenous content, localized anterior to the left kidney, being in intimate contact with the small bowel loops and the transverse colon. Surgery was performed and the mesenteric hematoma was completely removed. Histological examination revealed characteristic changes for encapsulated hematoma. Postoperative period was uneventful, the patient being disease free during 24 months follow-up.

Gh. Ghidirim

2009-08-01

270

Handheld Hematoma Detector  

Science.gov (United States)

This new device will allow a doctor or EMT to diagnose hematomas in patients with a traumatic brain injury at the scene of an accident or in other situations where full medical facilities are not available.

271

SPONTANEOUS MESENTERIC HEMATOMA  

OpenAIRE

Spontaneous small bowel mesentery or retroperitoneal hematomas are rare pathology occurring in absence of any trauma, anticoagulant therapy, vessel’s anomaly or systemic inflammatory disease. We present a case of a 23-year old male patient diagnosed with small bowel mesentery hematoma that corresponds to the „spontaneous” definition, who was admitted three days after onset accusing pain and a tumorous mass in the mesogastric region. Abdominal US and CT revealed a high density tumorous m...

Gh. Ghidirim; Mis?in, I.; Gh.Zastavni?chi; Condrat?chi, E.

2009-01-01

272

Cavernosal hematoma mimicking priapism.  

Science.gov (United States)

We present a case of corpus cavernosum hematoma mimicking priapism. A 42-year-old man presented to the emergency room with penile pain and partial erection. Examination revealed partial erection and palpable space-occupying lesion of the corpus cavernosum without lymphadenopathy. Malignant workup was negative. Imaging assisted in diagnosis of unilateral hematoma of the corpus cavernosum. The lesion spontaneously resolved without the need for intervention. PMID:25817127

Phillips, Elizabeth A; Menchini Fabris, Filippo; Mendoza, Pierre; Munarriz, Ricardo

2015-04-01

273

Acute subdural haematoma : a reappraisal.  

Directory of Open Access Journals (Sweden)

Full Text Available Acute subdural haematoma is a well-entrenched nosological entity implying subdural collection of blood following acute head injury. Pathologically, it is usually associated with or, for that matter, secondary to cerebral contusion and laceration. Based on cumulated experience, clinical and pathological studies it is proposed that, for too long the neurosurgeons have put emphasis on the clot rather than the totality of the pathological anatomy and that they have focused their therapeutic strategy on removal of the accumulated blood, unmindful of the associated parenchymatous lesion. Not surprisingly, such attempts have been associated with a very high mortality. On the basis of nearly four decades of personal experience and critical review of the literature, evidence has been provided that to reduce the mortality associated with this condition, it is necessary to evolve a strategy, not only to evacuate the blood but comprehensively deal with the associated parenchymatous lesions and the cascade of secondary insult to the underlying brain.

Tandon P

2001-01-01

274

Ultrasonographic findings of intrahepatic hematoma  

International Nuclear Information System (INIS)

Sequential ultrasonography was performed in 22 cases of intrahepatic hematomas diagnosed by operation, laboratory data, and clinical manifestation. We analyzed the shape, location, size of hematoma, and change in size and echogenicity by age of hematoma. The results were as follows: 1. The most common shape of intrahepatic hematoma was round. 2. The most common site of intrahepatic hematoma was the posterior segment of the right lobe of the liver. 3. Size of hematoma was decreased from 3rd day, and most hematomas were nearly or completely absorbed from 2nd week to 4th week. 4. Echogenecities of intrahepatic hematoma in immediate ultrasonography after injury showed mainly echogenic or mixed form, and then the echogenecities were decreased and nearly or completely not seen from 2nd week to 4th week

275

Computed tomographic findings of intramural hematoma  

International Nuclear Information System (INIS)

The CT findings of eleven patients with intramural hematoma of the gastrointestinal tract are presented. The most frequent site of intramural hematoma was duodenum(7/11). followed jejunum(2/11), ascending colon(2/11), stomach(1/11), and rectum(1/11). Blunt abdominal trauma was the prime etiologic factor(7/11). others included pancreatitis, iatrogenic and unknown. Intramural hematoma showed three patterns of CT characteristics: intramural mass(8/11), thickened bowel wall(1/11), and both(2/11). There were variable attenuation value of 10 cases of intramural mass; homogenous hyperdensity or hypodensity in each 3 cases, inhomogeneous or mixed density in 4 cases. Also there were peripheral lucent halo(1/10), pseudocapsule or dense rim(5/10), crescentic hyperdensity(2/10) and central hyperdense area(4/10). Associated CT features were hemoperitoneum(4), mesenteric infiltration, fatty liver, pancreatic confusion, and chronic pancreatitis. CT is the most accurate method in establishing the diagnosis or intramural hematoma, evaluating the extent of bleeding and its effect on adjacent organs, demonstrating regression after treatment, and detecting associating injury

276

Rectus sheath hematoma  

OpenAIRE

Abstract Abstract Rectus sheath hematoma (RSH) is a known complication of anticoagulation therapy and a source of potential morbidity and mortality. Early diagnosis and appropriate treatment may help to prevent complications including hemodynamic instability, the abdominal compartment syndrome or multiorgan dysfunction. Although the diagnosis can be made clinically, it can be confirmed with computed tomography of the abdomen. Most patients can b...

Osinbowale, Olusegun; Bartholomew, John R.

2008-01-01

277

Recidiva de empiema subdural postquirúrgico / Postoperative recurrence of subdural empyema  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Se presenta un caso de recidiva de infección postquirúrgica en forma de empiema subdural por Proprionibacterium acnes tras un primer empiema drenado en el que no se llegó al diagnóstico microbiológico. P acnes es un microorganismo gram positivo, anaerobio, que forma parte de la flora saprófita de la [...] piel y de otras zonas del organismo. Sin embargo puede producir infecciones, entre otras localizaciones, en el sistema nervioso central (SNC), especialmente infecciones postquirúrgicas en las que puede llegar a ser el segundo germen en frecuencia después de Staphylococcus aureus. Es de crecimiento lento y suele crecer mejor en medios anaeróbicos líquidos. Suele ser resistente al metronidazol y sensible a penicilinas. En las infecciones postquirúrgicas del sistema nervioso central hay que tener en cuenta la posibilidad de este microorganismo, procesar las muestras de forma adecuada y mantenernos en contacto con el Servicio de Microbiología. Abstract in english We present a case of recurrent subdural post-surgical empyema by Proprionibacterium acnes after a first drained empyema in which no microbiological diagnosis was reached. P. acnes is a gram-positive anaerobic organism which is part of the saprophytic flora of the skin and others parts of the body. H [...] owever, it can cause infections, as in the central nervous system, especially post-surgical infections in which can be the second more frequent organism after Staphylococcus aureus. P. acnes grows slowly and shows better growth in liquid anaerobic media. It is usually resistant to metronidazol and sensitive to penicillin. In postoperative central nervous system infections we must take into account the possibility of this organism, process the sample properly and keep touch with the Microbiology Department.

Y., Romero-Pizarro; M., Muñoz-Algarra; C., Fernández-Mateos; I., Sánchez-Romero.

2011-06-01

278

Acute spontaneous spinal subdural haematoma: MRI features  

International Nuclear Information System (INIS)

We present MRI findings in three patients with acute spontaneous subdural haematomas of the spine. Acute haematomas (1-3 days) were isointense or gave slightly high signal on T1- and heterogeneous signal on T2-weighted images. MRI precisely defined the level and extent of the haematoma preoperatively. The MRI was prospectively correctly interpreted as acute subdural haematomas in all patients. As a specific, noninvasive modality, MRI is the preferred imaging technique in this rare clinical entity. (orig.)

279

Acute subdural effusion in vasculitis  

Directory of Open Access Journals (Sweden)

Full Text Available We report a 29-year-old man with a unique presentation of vasculitis as acute unilateral subdural effusion and meningoencephalitis. Magnetic resonance imaging showed a brainstem lesion that spread to the thalamus over time. There were no systemic features of vasculitis other than a positive pathergy test. Histopathological examination from the pathergy site showed neutrophilic infiltrate and leucocytoclastic vasculitis. The condition was steroid responsive and he remained in remission at two years? follow-up. The anatomy of the brainstem lesion, absence of other inflammatory and infective conditions on evaluation suggests a vasculitic pathology either as primary central nervous system angiitis or as neurological presentation of systemic vasculitis like Beh?et?s disease although the international diagnostic criteria for Beh?et?s were not fulfilled.

Raghavendra Seetharam

2008-01-01

280

Spontaneous rectus sheath hematoma  

OpenAIRE

Abdominal wall pathology is a frequently overlooked cause of acute abdomen. Increasing use of antiplatelet and anticoagulant therapies has led to an increase in the incidence of spontaneous rectus sheath hematoma (RSH). A high index of suspicion is needed for diagnosis as it can closely mimic other causes of acute abdomen. Herein, we report a case of RSH presenting with abdominal pain in which there was a significant delay in diagnosis. We wish to highlight the need to increase awareness amon...

Alla, Venkata M.; Karnam, Showri M.; Kaushik, Manu; Porter, Joann

2003-01-01

281

Ethmoidal hematoma in nine horses.  

Science.gov (United States)

Ethmoidal hematoma was diagnosed in 9 horses by results of physical examination, endoscopy, radiography, and histologic examination of tissues. The horses had stertorous breathing (n = 4) or intermittently sanguineous nasal discharge (n = 7). All horses underwent sinusotomy and extirpation of the lesion. At reexamination 15 to 104 months after surgery (mean, 61 months), 3 horses had recurrence of ethmoidal hematoma, and 1 horse had ethmoidal hematoma involving the contralateral ethmoturbinates. One of the horses with recurrence of ethmoidal hematoma also developed a contralateral lesion; both lesions recurred and additional surgeries were performed. PMID:2211311

Specht, T E; Colahan, P T; Nixon, A J; Brown, M P; Turner, T A; Peyton, L C; Schneider, R K

1990-09-01

282

Acute aortic intramural hematoma  

International Nuclear Information System (INIS)

To evaluate the radiologic findings of acute intramural hematoma of the aorta, and the clinical follow up thereof. Among 34 cases confirmed clinically and radiologically as aortic dissection, and analysis was carried out based on 15 cases in which intramural hematoma without false lumen was demonstrated, on initial CT, 12 cases of in which follow up CT was used and five cases involving an aortogram. Elements such as the shape of the thickened aortic wall, ulcer-like intimal defects, and intimal calcification were examined. Changes in these elements were also examined on follow-up CT. DeBackey types 1 and 3 accounted for one and 14 cases, respectively. Initial precontrast CT demonstrated continuous, crescentic high attenuation areas along the wall of the descending aorta. In postcontrast scans, the crescentic areas were of relatively lower-attenuation and appeared along the aorta wall. Displaced intimal calcifications were seen in nine of fifteen patients. There was no intimal flap on all five aortogram, while aortic wall thickening and atherosclerotic change were demonstrated in four cases and in one case, respectively. Focal ulcers were seen in three cases. Ulcer-like intimal defects were demonstrated in a total of eleven cases (eight on CT, two on aortogram, and one on both). In ten of the twelve cases seen on follow up CT, the thickness of the intramural hematoma was seen to be reduced. Among the 15 cases, the operation was performed in two cases, and the remaining performed in two cases, and the remaining 13 received conservative treatment. In ten cases observed for more than twelve months, a recurrence of symptoms did not occur. Eccentric aortic wall thickening in patients who complain of acute chest pain is the result of acute aortic dissection with intramural hematoma, or a penetrating atherosclerotic ulcer of the aorta. The later may be differentiated from the former by the presence of on ulcer-like intimal defect. When both diseases are limited to the descending aorta, conservative treatment may be effective, unless patients experience persistent or recurrent chest pain, or unless intramural hematoma progresses further

283

Cerebral cysticercus granuloma associated with a subdural effusion.  

OpenAIRE

The association of a solitary cerebral cysticercus granuloma with a subdural effusion is being reported. The granuloma and the effusion resolved following albendazole therapy. We speculate that the spread of the inflammatory changes around the granuloma to the subdural space could have led to the development of the subdural effusion.

Rajshekhar V

2001-01-01

284

The computed tomographic findings of peritentorial subdural hemorrhage  

Energy Technology Data Exchange (ETDEWEB)

The computed tomographic (CT) findings in six cases of subdural hemorrhage in the peritentorial region are listed and discussed. The CT appearance of peritentorial subdural hemorrhage sometimes mimicks that of intra-axial lesions, but coronal scanning or reconstruction can be used to resolve this problem. Awareness of this unusual location for subdural hemorrhage is helpful in providing an accurate preoperative diagnosis.

Lau, L.S. (Prince Henry' s Hospital, Melbourne, Victoria, Australia); Pike, J.W.

1983-03-01

285

The computed tomographic findings of peritentorial subdural hemorrhage.  

Science.gov (United States)

The computed tomographic (CT) findings in six cases of subdural hemorrhage in the peritentorial region are listed and discussed. The CT appearance of peritentorial subdural hemorrhage sometimes mimicks that of intra-axial lesions, but coronal scanning or reconstruction can be used to resolve this problem. Awareness of this unusual location for subdural hemorrhage is helpful in providing an accurate preoperative diagnosis. PMID:6828684

Lau, L S; Pike, J W

1983-03-01

286

The computed tomographic findings of peritentorial subdural hemorrhage  

International Nuclear Information System (INIS)

The computed tomographic (CT) findings in six cases of subdural hemorrhage in the peritentorial region are listed and discussed. The CT appearance of peritentorial subdural hemorrhage sometimes mimicks that of intra-axial lesions, but coronal scanning or reconstruction can be used to resolve this problem. Awareness of this unusual location for subdural hemorrhage is helpful in providing an accurate preoperative diagnosis

287

Spontaneous Rectus Sheath Hematoma  

Directory of Open Access Journals (Sweden)

Full Text Available Abdominal wall pathology is a frequently overlooked cause of acute abdomen. Increasing use of antiplatelet and anticoagulant therapies has led to an increase in the incidence of spontaneous rectus sheath hematoma (RSH. A high index of suspicion is needed for diagnosis as it can closely mimic other causes of acute abdomen. Herein, we report a case of RSH presenting with abdominal pain in which there was a significant delay in diagnosis. We wish to highlight the need to increase awareness among primary and emergency physicians about considering RSH in the initial differential diagnoses of abdominal pain. [West J Emerg Med. 2010; 11(1:76-79].

Alla, Venkata M

2010-02-01

288

Spinal epidural hematomas  

DEFF Research Database (Denmark)

During the period 1943-1985 six patients were operated for spinal epidural hematomas at the department of neurosurgery of the University Hospital of Arhus. It is essential to perform acute laminectomy in case of rapidly increasing neurological symptoms. In the case of slowly increasing symptoms operation may provide a good result even if it is performed a week after the onset of symptoms. It is important to watch patients with fracture/dislocations of the spine closely during the first weeks after a trauma. If they develop neurological symptoms the patients should immediately be transferred to the department of neurosurgery with a view of

Laursen, J; Fode, K

1987-01-01

289

Subdural hygroma after craniosynostosis remodeling surgery.  

Science.gov (United States)

Craniosynostosis is defined as the premature fusion of the cranial sutures and can cause functional impairment or cosmetic deformity. Surgical techniques for the correction of craniosynostosis have changed overtime, as so have the intraoperative and postoperative complications. Extensive surgeries involving fronto-orbital unit repositioning and cranial vault remodeling are associated with various complications. Intraoperative and postoperative hemorrhage, venous infarct, air embolism, hydrocephalus, cerebrospinal fluid leak, as well as meningitis are a few complications associated with cranial vault remodeling surgery. Postoperative complications can increase the morbidity and mortality associated with these procedures. Identification of the complications and their timely management should be a part of every craniofacial reconstruction team's training program.In this article, we report a case of subdural hygroma in an infant after cranial vault remodeling procedure. Subdural hygroma is a known complication following head injuries and represents 5% to 20% of posttraumatic intracranial mass lesions. However, subdural hygroma developing after a cranial procedure is rare and has not been reported in the literature. Identification of the complication, close monitoring of the change in subdural fluid volume, and tapping of the fluid through the craniotomy site if indicated form the mainstay of management of subdural hygroma that develops after cranial vault remodeling surgery. PMID:25469899

Ganesh, Praveen; Nagarjuna, Muralidhara; Shetty, Samarth; Salins, Paul C

2015-01-01

290

Calcified subdural haematomas associated with arrested hydrocephalus - late sequelae of shunt operation in infancy  

Energy Technology Data Exchange (ETDEWEB)

Calcified chronic subdural haematoms (SDH) and features of arrested (compensated) hydrocephalus were demonstrated by skull radiography and cranial computed tomography (CT) in two children who had no neurological deficit. Ventricular surgical drainage had been performed 8 and 11 years prior to admission and the haematomas remained subsequently undetected. The following presentation will serve to illustrate the characteristic radiological features of this entity, the issue of management, and includes a review of the literature.

Barmeir, E.P.; Stern, D.; Harel, S.; Holtzman M.; Krije, T.J.

1985-08-01

291

Coleção subdural na criança: fisiopatologia e tratamento / Subdural effusions in children: pathophysiology and treatment  

Scientific Electronic Library Online (English)

Full Text Available Nove crianças portadoras de coleção subdural (CSD) foram tratadas por meio de derivação subduro-peritoneal. Todas foram submetidas a controle com tomografia computadorizada do encéfalo. O tamanho da coleção subdural foi avaliado por medida de sua área no corte tomográfico por meio de morfologia quan [...] titativa com planímetro. Ocorreu regressão completa ou quase completa da CSD em oito pacientes. Os resultados funcionais foram excelentes em quatro pacientes, bons em três e maus em dois. Foi feita uma revisão da fisiopatologia e do tratamento da CSD na criança. Abstract in english Nine children harboring subdural effusions were treated by subduro peritoneal shunt. These patients were followed-up by CT scans. The area of the subdural effusions was measured by quantitative morphology with a planimeter. With the surgical treatment, the subdural effusion disappeared completely or [...] near completely in 8 patients. The patient's functional state were excellent in 4, good in 3 and bad in 2 in the postoperative follow-up. We aldo reviewed the literature as far as the pathophysiology and the treatment of the subdural effusions are concerned.

Sebastião, Gusmão; Roberto Leal, Silveira; Guilherme, Cabral Filho; Aluízio, Arantes; Charles, Jermani.

1997-06-01

292

Hepatostomy for central hepatic hematomas  

International Nuclear Information System (INIS)

Two patients with central hepatic hematomas are presented. Hepatostomy tube drainage provided prompt healing of the cavities without complications. The technique is presented as a safe and effective alternative to hepatic resection without compromising the established principles of management

293

Spontaneous intraorbital hematoma: case report  

Directory of Open Access Journals (Sweden)

Full Text Available Vinodan Paramanathan, Ardalan ZolnourianQueen's Hospital NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, UKAbstract: Spontaneous intraorbital hematoma is an uncommon clinical entity seen in ophthalmology practice. It is poorly represented in the literature. Current evidence attributes it to orbital trauma, neoplasm, vascular malformations, acute sinusitis, and systemic abnormalities. A 65-year-old female presented with spontaneous intraorbital hematoma manifesting as severe ocular pains, eyelid edema, proptosis, and diplopia, without a history of trauma. Computer tomography demonstrated a fairly well defined extraconal lesion with opacification of the paranasal sinuses. The principal differential based on all findings was that of a spreading sinus infection and an extraconal tumor. An unprecedented finding of a spontaneous orbital hematoma was discovered when the patient was taken to theater. We discuss the rarity of this condition and its management.Keywords: hemorrhage, ophthalmology, spontaneous, intra-orbital, hematoma

Vinodan Paramanathan

2010-12-01

294

Spontaneous intraorbital hematoma: case report  

OpenAIRE

Vinodan Paramanathan, Ardalan ZolnourianQueen's Hospital NHS Foundation Trust, Burton on Trent, Staffordshire DE13 0RB, UKAbstract: Spontaneous intraorbital hematoma is an uncommon clinical entity seen in ophthalmology practice. It is poorly represented in the literature. Current evidence attributes it to orbital trauma, neoplasm, vascular malformations, acute sinusitis, and systemic abnormalities. A 65-year-old female presented with spontaneous intraorbital hematoma manifesting as se...

Vinodan Paramanathan; Ardalan Zolnourian

2010-01-01

295

Prevention of Hematomas and Seromas  

OpenAIRE

Hematoma and seroma formation in surgical wounds has negative effects on wound healing and subsequent morbidity to patients. This is of particular pertinence in cosmetic procedures in which the patient has chosen to undergo surgery electively. Over the past several decades there has been considerable interest in the use of ancillary techniques to assist in closing wounds and achieving hemostasis to prevent hematoma and seroma formation. These techniques include application of tissue sealants ...

Bullocks, Jamal; Basu, C. Bob; Hsu, Patrick; Singer, Robert

2006-01-01

296

Whole Spontaneous Spinal Epidural Hematoma  

OpenAIRE

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterio...

Yoon, Kyeong-wook; Song, Jae Gyok; Ryu, Jae-wook; Kim, Young-jin

2014-01-01

297

Traumatic posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

298

Computed tomography of traumatic extradural hematoma  

International Nuclear Information System (INIS)

Since the introduction of CT in February, 1977, 64 cases with 67 traumatic extradural hematomas were experienced. These cases were analysed, especially with regard to CT findings of the hematomas, small extradural hematomas, and combined intracerebral hematomas, and the correlation between CT gradings and clinical outcomes. From these analyses, the following results were obtained. In 64 out of 66 hematomas, except for a case of sagittal sinus hematoma, shapes were biconvex on CT scans. The other two were planconvex and crescent. One sagittal sinus hematoma could not be diagnosed by CT alone because the highest parietal slice was not taken. In 60 acute hematomas, densities of 59 were high. The other one was hypo- or iso-dense. In six subacute hematomas, two were hypo- and iso-dense respectively. These two cases showed a marked dural enhancement for contrast material. Initial admission CT scans disclosed 35 large hematomas (> 20 mm in thickness) and 29 small ones (<= 20 mm). The other three were not clear in the initial CT scans. Among 12 small hematomas for which initial CT scans were performed within 6 hours after injury and sequential CT scans were carried out, six were shown to become larger. Three of these were operated on thereafter. Eleven cases with small hematomas on the initial CT scans were operated on. Their bleeding sources were the middle meningeal arteries in three cases, dural vein in one, fracture sites in four, and unclear in three. In 16 combined intr and unclear in three. In 16 combined intradural lesions, ten were traumatic intracerebral hematomas. Four of these intracerebral hematomas were found simultaneously with extradural ones in CT scans. Six were obviously found later than the latter. Two cases with multiple extradural hematomas were reported. After evacuation of one extradural hematoma, additional extradural and intracerebral hematomas developed at other sites in these cases. (author)

299

The computer tomographic appearances of subdural empyemas  

International Nuclear Information System (INIS)

The computer tomographic appearances of subdural empyemas are described, based on 17 cases. The empyema appears underneath the calvarium as a sickle of half-moon shaped translucency. It is separated from the surface of the brain by a narrow opacity which is greatly enhanced by contrast medium. Most cases showed, in addition, a local reaction of the brain due to an encephalitis which resulted in an expansive process greater than that due to the empyema itself. (orig.)

300

Ultrasound diagnosis of rectus sheath hematoma  

International Nuclear Information System (INIS)

6 cases of rectus sheath hematoma were correctly diagnosed by ultrasound. 2 cases had bilateral rectus sheath hematoma and 4 cases were unilateral. On ultrasound finding, relatively well defined oval or spindle like cystic mass situated in the area of rectus muscle on all cases. Ultrasound examination may give more definite diagnosis and extension rectus sheath hematoma and also helpful to follow up study of hematoma

301

Optimal management of hemophilic arthropathy and hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available Sébastien Lobet,1,2 Cedric Hermans,1 Catherine Lambert1 1Hemostasis-Thrombosis Unit, Division of Hematology, 2Division of Physical Medicine and Rehabilitation, Cliniques Universitaires Saint-Luc, Brussels, Belgium Abstract: Hemophilia is a hematological disorder characterized by a partial or complete deficiency of clotting factor VIII or IX. Its bleeding complications primarily affect the musculoskeletal system. Hemarthrosis is a major hemophilia-related complication, responsible for a particularly debilitating chronic arthropathy, in the long term. In addition to clotting factor concentrates, usually prescribed by the hematologist, managing acute hemarthrosis and chronic arthropathy requires a close collaboration between the orthopedic surgeon and physiotherapist. This collaboration, comprising a coagulation and musculoskeletal specialist, is key to effectively preventing hemarthrosis, managing acute joint bleeding episodes, assessing joint function, and actively treating chronic arthropathy. This paper reviews, from a practical point of view, the pathophysiology, clinical manifestations, and treatment of hemarthrosis and chronic hemophilia-induced arthropathy for hematologists, orthopedic surgeons, and physiotherapists. Keywords: hemophilia, arthropathy, hemarthrosis, hematoma, physiotherapy, target joint

Lobet S

2014-10-01

302

Whole spontaneous spinal epidural hematoma.  

Science.gov (United States)

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterioration was recovered immediately, and he was discharged without neurological deficits. A drug history of naftazone, which could induce a drug-induced platelet dysfunction, was revealed retrospectively. To our knowledge, this is the first report of whole spontaneous spinal epidural hematoma in a young patient, with a history of hemorrhoid medication. PMID:24967052

Yoon, Kyeong-Wook; Song, Jae Gyok; Ryu, Jae-Wook; Kim, Young-Jin

2014-06-01

303

Subdural Hematoma: An Adverse Event of Electroconvulsive Therapy—Case Report and Literature Review  

OpenAIRE

Electroconvulsive therapy (ECT) is commonly used in the management of medication nonresponsive depressive disorder, with proven efficacy in psychiatric practice since many decades. A rare complication of intracranial bleed following this therapeutic procedure has been reported in sporadic case reports in the English literature. We report a case of such a complication in a 42-year-old male, a known case of nonorganic medication nonresponsive depressive disorder for the last two years who requi...

Kulkarni, Ranganath R.; Melkundi, Sateesh

2012-01-01

304

Giant acute epidural hematoma after ventriculoperitoneal shunt: a case report and literature review.  

Science.gov (United States)

Cerebrospinal fluid over-drainage is a common complication of ventriculoperitoneal devices. In terms of haemorrhage, subdural haematomas are usually more frequent lesions than epidural hematomas, which, more rarely, may also be seen after ventricular shunt procedures and may lead to rapid neurological decline and even death unless a surgical procedure can be promptly performed. This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosis of normal pressure hydrocephalus submitted to a ventriculoperitoneal shunt with a high fixed pressure valve. After discharge, on the second day after the procedure, he presented with headache and impaired level of consciousness. At hospital admission he was in a coma and anisochoric. Underwent endotracheal intubation and a head CT, showed epidural hematoma. We performed emergency craniotomy to drain the hematoma, the patient died in the operating room despite resuscitation attempts. In conclusion, prompt diagnosis and emergency craniotomy is recommended in these cases. We must be aware of this possible evolution and maintain high suspicion besides a longer in-hospital observation after these procedures. PMID:25232436

Noleto, Gustavo; Neville, Iuri Santana; Tavares, Wagner Malagó; Saad, Felippe; Pinto, Fernando Campos; Teixeira, Manoel Jacobsen; Paiva, Wellingson Silva

2014-01-01

305

Microwave Hematoma Detector for the Rapid Assessment of Head Injuries  

Energy Technology Data Exchange (ETDEWEB)

A non-invasive microwave device for the detection of epi/subdural hemorrhaging (hematoma) is under current development. The final device will be highly portable and allow real time assessment of head injuries, thereby satisfying early detection needs of the field technician as well as providing a tool for repetitious monitoring of high-risk individuals. The device will adopt the advanced technology of micropower impulse radar (MIR) which is a state of the art low cost ultra wide band (UWB) microwave radar developed here at LLNL. It will consist of a MIR transmitting and receiving module, a computer based signal processing module, and a device-to-patient signal coupling module--the UWB antenna. The prototype design is being guided by the needs of the patient and the practitioner along with the prerequisites of the technology including issues such as the specificity of the device, efficacy of diagnosis, accuracy, robustness, and patient comfort. The prototype development follows a concurrent approach which .includes experiments designed to evaluate requirements of the radar and antenna design, phantom development to facilitate laboratory investigations, and investigation into the limits of adapting pre-existing non-medical MIR devices to medical applications. This report will present the accomplishments and project highlights to date in the fiscal year 1999. Future project projections will also be discussed.

Hadded, W.; Chang, J.; Rosenbury, T.; Dallum, G.; Welsch, P.; Scott, D.; Duarte, D.; Acevedo-Bolton, V.

2000-02-11

306

Is human fracture hematoma inherently angiogenic?  

LENUS (Irish Health Repository)

This study attempts to explain the cellular events characterizing the changes seen in the medullary callus adjacent to the interfragmentary hematoma during the early stages of fracture healing. It also shows that human fracture hematoma contains the angiogenic cytokine vascular endothelial growth factor and has the inherent capability to induce angiogenesis and thus promote revascularization during bone repair. Patients undergoing emergency surgery for isolated bony injury were studied. Raised circulating levels of vascular endothelial growth factor were seen in all injured patients, whereas the fracture hematoma contained significantly higher levels of vascular endothelial growth factor than did plasma from these injured patients. However, incubation of endothelial cells in fracture hematoma supernatant significantly inhibited the in vitro angiogenic parameters of endothelial cell proliferation and microtubule formation. These phenomena are dependent on a local biochemical milieu that does not support cytokinesis. The hematoma potassium concentration is cytotoxic to endothelial cells and osteoblasts. Subcutaneous transplantation of the fracture hematoma into a murine wound model resulted in new blood vessel formation after hematoma resorption. This angiogenic effect is mediated by the significant concentrations of vascular endothelial growth factor found in the hematoma. This study identifies an angiogenic cytokine involved in human fracture healing and shows that fracture hematoma is inherently angiogenic. The differences between the in vitro and in vivo findings may explain the phenomenon of interfragmentary hematoma organization and resorption that precedes fracture revascularization.

Street, J

2012-02-03

307

Spontaneous spinal epidural hematoma diagnosed by CT scan  

International Nuclear Information System (INIS)

A case of spinal epidural hematoma diagnosed by CT scan is reported. A 58-year-old man was admitted on June 18, 1984. He had had a sudden onset of severe low-back pain 7 days before admission and had developed paraparesis and numbness of the lower limbs 4 day before admission. Physical examination revealed weakness in the lower limbs, with the reflexes there decreased. The Babinski reflex and the Chaddock reflex were, however, present on both sides. Sensory disturbances were noted below L2. Urinary incontinence was present, too. Metrizamide myelography revealed an epidural mass which was located from the power part of T11 to the upper part of L2. A CT scan revealed a biconvex, relatively high-density mass in the posterior spinal canal. On the day of admission, a laminectomy was performed from T11 to L1, and the epidural hematoma was evacuated. The postoperative course was uneventful. Spinal epidural hematoma is uncommon. A CT scan can be used for an early diagnosis of this lesion. According to the review of the CT findings in 15 reported cases, including our case, CT reveals a smoothly marginated biconvex homogeneous density mass. The density of the hematoma decreases with the time. An acute type (within 3 days) is high-density, while a chronic type has a relatively high or isodensity. The acute type is easily differentiated from other epidural masses, such as a herniated disc, an epidural abscess, and an epiduraldisc, an epidural abscess, and an epidural tumor. On the other hand, the diagnosis of the chronic type is not always easy. (author)

308

Subdural and intracerebral hemorrhage caused by spontaneous bleeding in the middle meningeal artery after coil embolization of a cerebral aneurysm.  

Science.gov (United States)

Nontraumatic acute subdural hemorrhage (SDH) with intracerebral hemorrhage (ICH) is rare and is usually caused by severe bleeding from aneurysms or arteriovenous fistulas. We encountered a very rare case of spontaneous bleeding from the middle meningeal artery (MMA), which caused hemorrhage in the temporal lobe and subdural space 2 weeks after coil embolization of an ipsilateral, unruptured internal cerebral artery aneurysm in the cavernous portion. At onset, the distribution of hematoma on a computed tomography scan led us to believe that the treated intracavernous aneurysm could bleed into the intradural space. Emergency craniotomy revealed that the dura of the middle fossa was intact except for the point at the foramen spinosum where the exposed MMA was bleeding. Retrospectively, angiography just before and after embolization of the aneurysm did not show any aberrations in the MMA. Although the MMA usually courses on the outer surface of the dura and is unlikely to rupture without an external force, physicians should be aware that the MMA may bleed spontaneously and cause SDH and ICH. PMID:25134456

Kohyama, Shinya; Kakehi, Yoshiaki; Yamane, Fumitaka; Ooigawa, Hidetoshi; Kurita, Hiroki; Ishihara, Shoichiro

2014-10-01

309

Interventricular septum hematoma during cineventriculography  

OpenAIRE

Abstract Background Intraseptal hematoma and subsequent myocardial infarction due to accidental contrast agent deposition complicating diagnostic cineventriculography is a previously undescribed complication of angiography. Case presentation A 61 year old man was admitted at intensive care unit because of unstable angina pectoris 1 hour after coronary angiography. Transthoracic contrast echocardiography showed a non-perfused area in the middle of interventricular septum with an increase of th...

Melzer Christoph; Rutsch Wolfgang; Knebel Fabian; Eddicks Stephan; Elgeti Thomas; Grohmann Andrea; Baumann Gert; Borges Adrian C

2008-01-01

310

Ethmoid Hematoma of the Equine  

OpenAIRE

Two cases of ethmoid hematoma of the equine are reported. Clinically both horses had intermittent unilateral epistaxis unassociated with exercise. In one horse, diagnosis was based on the use of an endoscope for visualization and for biopsy of a mass associated with the ethmoid turbinates. In the other horse, exploratory trephination of the posterior maxillary sinus was necessary to obtain a diagnostic biopsy specimen. Radiography was helpful in the diagnosis of one case. Surgical removal of ...

Etherington, W. G.; Vasey, J. R.; Horney, F. D.

1982-01-01

311

Interventricular septum hematoma during cineventriculography  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Intraseptal hematoma and subsequent myocardial infarction due to accidental contrast agent deposition complicating diagnostic cineventriculography is a previously undescribed complication of angiography. Case presentation A 61 year old man was admitted at intensive care unit because of unstable angina pectoris 1 hour after coronary angiography. Transthoracic contrast echocardiography showed a non-perfused area in the middle of interventricular septum with an increase of thickening up to 26 mm. Review of cineventriculography revealed contrast enhancement in the interventricular septum after contrast medium injection and a dislocation of the pigtail catheter tip. Follow up by echocardiography and MRI showed, that intramural hematoma has resolved after 6 weeks. After 8 weeks successful stent implantation in LAD was performed and after 6 month the patient had a normal LV-function without ischemic signs or septal thickening demonstrated by stressechocardiography. Conclusion A safe and mobile position of the pigtail catheter during ventriculography in the middle of the LV cavity should be ensured to avoid this potentially life-threatening complication. For assessment and absolute measurement of intramural hematoma contrast-enhanced echocardiography is more feasible than MRI and makes interchangeable results.

Melzer Christoph

2008-01-01

312

Spontaneous renal hematoma - a case report  

International Nuclear Information System (INIS)

Spontaneous pararenal hematoma is a rare pathology most frequently coexisting with renal tumours, vascular anomalies and inflammatory processes. In some cases one cannot establish its etiology. The paper describes a case of a 58-year-old man with a spontaneous pararenal hematoma and presents a diagnostic algorithm. Ultrasonography and CT play an important role in diagnostics of spontaneous pararenal haemorrhages. These methods enable a precise evaluation of size and location of hematoma and its evolution. (author)

313

Traumatic bilateral intraorbital (subperiosteal) hematoma associated with epidural hematoma: case report Hematoma intraorbitário bilateral traumático associado a hematoma epidural: relato de caso  

OpenAIRE

Extradural hematoma (EDH) is a frequent lesion, with an incidence varying from 0.2 to 6% in patients admitted to hospital due to traumatic head injury. The higher incidence is found in patients with more severe injuries. The association of EDH with subperiosteal intraorbital hematomas is rarely reported, and we were not able to find in the literature any report of traumatic bilateral intraorbital hematomas and EDH. We report this case of a 32 year-old man with bilateral intraorbital (subperio...

Leodante Batista da Costa Jr; Agustinho de Andrade; José Gilberto de Bastos Henriques; Anderson Finotti Cordeiro; Cícero do Juazeiro Job Maciel

2003-01-01

314

Subungual frictional hematoma due to overriding toe  

Directory of Open Access Journals (Sweden)

Full Text Available We report a male patient of 77 years with subungual frictional hematoma secondary to the deformity of his toe (overriding toe, this finding was incidental during his examination due to the presence of seborrheic keratosis on the scalp.Subungual hematomas of the nails are common it could be cause by major and minor trauma predominantly on the big toe, the different toe deformity predispose to have subungual frictional hematoma like in the present clinical case.

Chang Patricia

2011-07-01

315

Spinal epidural hematoma during anticoagulant therapy. A case report and review of the literature.  

Science.gov (United States)

The authors present a case of spinal epidural hematoma during anticoagulant therapy. Clinical presentation is characterized by classic paravertebral back pain, followed by progressive neurological deficit due to spinal cord and radicular compression, with sensory deficits and bladder disturbance. From the literature, 37 cases are collected of spinal epidural hematoma during anticoagulant therapy, treated surgically. Pathogenesis, diagnosis, and differential diagnosis are discussed. Early surgical decompression of the spinal cord minimizes the degree of permanent neurological damage, because of the long-time compression of the spinal cord resulting in irreversible disturbance of circulation; therefore an early diagnosis is a better prognosis. The thoracic and cervical spine canal is smaller than the lumbar, therefore there is less space to reward the formation of hematomas, consequently the postoperative recovery is lower in patient with high spinal epidural hematomas with respect to lumbo-sacral spinal epidural hematomas; at this level the epidural hematoma may be insidious in its onset and tends to become chronic before definite treatment is undertaken. PMID:8568560

Rodriguez y Baena, R; Gaetani, P; Tancioni, F; Tartara, F

1995-03-01

316

Dolor radicular como forma de presentación de un hematoma epidural espontáneo / Radicular pain as way of presentation of a spontaneous spinal epidural hematoma: a case presentation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: las hemorragias espontáneas dentro del estuche espinal en las edades pediátricas son poco frecuentes. La sangre puede extenderse por el espacio epidural, subdural o intramedular y producir compresión de las estructuras neurales. El espacio epidural es la zona más vulnerable a sufrir el s [...] angrado y dentro de éste su porción posterior. Objetivo: presentar un caso poco frecuente de hematoma epidural espinal cervical espontáneo que debutó con signos radiculares. Caso Clínico: paciente masculino de 14 años de edad con antecedentes de salud que es remitido a la consulta con una historia iniciada siete días antes, caracterizada por: dolor cervical bajo, de moderada intensidad de inicio brusco y que se irradiaba a los dermatomas cervicales 4 a 6 (C4-C6). Al examen físico se pudo constatar dolor al percutir las apófisis espinosas de C4 a C6, hiporreflexia bicipital y reducción de la fuerza en la pinza digital derecha. Se realizó una resonancia magnética nuclear cervical, donde se pudo diagnosticar un hematoma epidural espinal espontáneo que se extendía anteriormente desde C3 a C7. Se decidió el tratamiento médico y el paciente egresó a los doce días libre de manifestaciones clínicas. Conclusiones: la evolución clínica del paciente, el tamaño, la localización del hematoma y tiempo de evolución de la enfermedad son elementos a tener en cuenta a la hora de seleccionar la modalidad del tratamiento, el cual permitirá la reversibilidad de los síntomas y signos neurológicos así como el desarrollo de complicaciones tardías. Abstract in english Background:spontaneous hemorrhages inside the spinal case in pediatric ages are not frequent. The blood may extend over the epidural, subdural or intramedular space, producing compression of neural structures. The epidural space is the most vulnerable area to suffer bleeding and inside of this, its [...] posterior portion. Objective: to present an infrequent case of spontaneous cervical spinal epidural hematoma that started with radicular signs. Clinical case: a 14 years old, masculine patient with health antecedents is remitted to the consulting room with a history initiated seven days before, characterized for: low cervical pain of moderate intensity, of abrupt onset, irradiating to the 4 at 6 cervical dermatomes (C4-C6). To the physical examination was verified pain when striking the C4 to C6, bicipital hyporeflexia and reduction of the force in the right digital forceps. A cervical nuclear magnetic resonance was performed, where a spontaneous spinal epidural hematoma was diagnosed that previously extended from C3 to C7. The medical treatment was decided, the patient was discharged to twelve days, free of clinical manifestations. Conclusions: the patient's clinical evolution, size, localization of the hematoma and the time of evolution of the disease are elements to keep in mind when selecting the modality of the treatment, which will allow the reversibility of symptoms and neurological signs as well as the development of late complications.

Isael, Olazábal Armas.

2011-02-01

317

Intra-uterine hematoma in pregnancy.  

DEFF Research Database (Denmark)

In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week of detection was found. A subplacentar localization of the hematoma was associated with a higher, but not statistically significant, incidence of spontaneous abortion than a subchorionic localization. Spontaneous abortion most often occurred in the first weeks after the formation of the hematoma. Udgivelsesdato: 1991-Jun-5

Glavind, K; NØhr, S

1991-01-01

318

Unoperated giant cerebellar hematoma: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available The treatment of patients with spontaneous intracerebellar hematoma (SIH still remains controversial. Computerized tomography (CT offers early and accurate diagnosis of SIH, the size and location of SIH can be precisely defined. The main prognostic factors affecting the outcome are the clinical state of the patient on admission, the size and localization of the hematoma, compression of brain-stem, and the presence of intraventricular hematoma and hydrocephalus. In this report, a 62 year old female patient with a giant cerebellar hematoma who was treated medically was presented.

Gezen, F.

2005-01-01

319

Hematoma da aorta ascendente Intramural hematoma of the ascending aorta  

Directory of Open Access Journals (Sweden)

Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM, quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco, com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento.It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement of the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM, the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical correction, being accomplished by resection of the ascending aorta and part of the aortic arch (hemiarch, with preservation of the aortic valve with suspension of the comissures. The patient had ununventfull recovery, being discharged in the 9th postoperative day. We emphasized the similarity of the clinical presentation of the intramural hematoma of the aorta with that of aortic dissection, the importance of establishing correct diagnosis and the best treatment.

Noedir Antônio G. Stolf

2006-12-01

320

Hematoma da aorta ascendente / Intramural hematoma of the ascending aorta  

Scientific Electronic Library Online (English)

Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A [...] radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM), quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco), com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento. Abstract in english It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement o [...] f the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM), the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical correction, being accomplished by resection of the ascending aorta and part of the aortic arch (hemiarch), with preservation of the aortic valve with suspension of the comissures. The patient had ununventfull recovery, being discharged in the 9th postoperative day. We emphasized the similarity of the clinical presentation of the intramural hematoma of the aorta with that of aortic dissection, the importance of establishing correct diagnosis and the best treatment.

Noedir Antônio G., Stolf; Anderson, Benício; Gustavo I., Judas; Roberto Rocha Correia Veiga, Giraldez; Wilson, Mathias Júnior.

2006-12-01

321

Intramural duodenal hematoma as a complication of therapy with Warfarin: a case report and literature review  

International Nuclear Information System (INIS)

We report a case of a patient receiving chronic oral anticoagulant therapy with Warfarin who presented with acute intestinal obstruction. Computed tomography showed intramural duodenal hematoma. Treatment was conservative with correction of the coagulation parameters and observation. This case exemplifies the usefulness of conservative therapy and computed tomography in patients with acute small bowel obstruction receiving anticoagulant therapy. (author)

322

Spontaneous spinal epidural hematoma: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Spontaneous spinal epidural hematoma is a rare clinical disorder that might result in permanant neurological deficit and death when left untreated. We present a 34 year old male admitted to our emergency department with back pain and paraplegia, and being diagnosed with spontaneous spinal epidural hematoma.

Selami Cagatay ONAL

2010-01-01

323

Polyarteritis nodosa presenting with spontaneous perirenal hematoma  

OpenAIRE

Spontaneous perirenal hematoma following ruptured microaneurysm is an unusual but serious complication of polyarteritis nodosa. We describe a young male who presented with spontaneous perirenal hematoma and was subsequently diagnosed to have polyarteritis nodosa. He was managed with immunosuppressive medications with no recurrence of symptoms.

Mukhopadhyay, P.; Rathi, M.; Kohli, H. S.; Jha, V.; Gupta, K. L.; Sakhuja, V.

2012-01-01

324

Multiple cerebral hematoma and viral encephalitis  

International Nuclear Information System (INIS)

A patient with the clinical diagnosis of brain abcess presented with a CT brain scan showing an intracerebral hematoma. Subsequently bilateral spontaneous hyperdense lesions appeared. Autopsy showed the typical findings of viral encephalitis probably due to herpes simplex. It is stressed that the differential diagnosis of intracerebral hematoma includes viral encephalitis in the proper clinical setting. (orig.)

325

Multiple cerebral hematoma and viral encephalitis  

Energy Technology Data Exchange (ETDEWEB)

A patient with the clinical diagnosis of brain abcess presented with a CT brain scan showing an intracerebral hematoma. Subsequently bilateral spontaneous hyperdense lesions appeared. Autopsy showed the typical findings of viral encephalitis probably due to herpes simplex. It is stressed that the differential diagnosis of intracerebral hematoma includes viral encephalitis in the proper clinical setting.

Zegers de Beyl, D.; Noterman, J.; Martelart, A.; Baleriaux, D.; Flament-Durand, J.

1980-08-01

326

Multiple cerebral hematoma and viral encephalitis.  

Science.gov (United States)

A patient with the clinical diagnosis of brain abcess presented with a CT brain scan showing an intracerebral hematoma. Subsequently bilateral spontaneous hyperdense lesions appeared. Autopsy showed the typical findings of viral encephalitis probably due to herpes simplex. It is stressed that the differential diagnosis of intracerebral hematoma includes viral encephalitis in the proper clinical setting. PMID:7422119

Zegers de Beyl, D; Noterman, J; Martelart, A; Flament-Durand, J; Baleriaux, D

1980-08-01

327

Hematoma hepático subcapsular por fasciola  

Scientific Electronic Library Online (English)

Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Presentamos el caso de una mujer de 22 años de edad, natural de Huaraz con historia de dolor en hipocondrio derecho asociado a náuseas y vómitos que se intensifican tres dias antes de su admisión. Al examen se encuentra disminución del murmullo vesicular en la base del hemitórax derecho. El abdomen [...] es doloroso a la palpación en el epigastrio e hipocondrio derecho. El hígado se palpa a 3 cm debajo del reborde costal; Hemograma con eosinofilia severa. Se aprecia leve colestasis. Ecografía abdominal: Masa hepática heterogénea de 13 cm de diámetro en el lóbulo derecho. Tomografía axial computarizada: Masa subcapsular de 14x8 cm. Gammagrafía: Hígado con área hipocaptadora que muestra ausencia de perfusión al pool vascular. Se somete a laparotomía exploratoria y se encuentra hematoma subcapsular de 800 cc en segmento 6, 7 y 8, el cual se drena. En la evolución persite la eosinofilia y se obtiene Arco 2 positivo para Fasciola. Recibió triclabendazol, actualmente asintomática. Conclusión: La fase invasiva de la fasciolosis humana puede ocasionar hematoma hepático como una complicación rara. La triada de eosinofilia persistente, hepatomegalia dolorosa y fiebre prolongada, orienta a insistir en la búsqueda de fasciolasis en zonas endémicas. Abstract in english The case of a 22 year old woman from Huaraz is presented herein. She suffered from pain at right hypocondrium, associated to nausea and vomits, which intensified three days prior to admission. Upon examining her, a faded gallbladder murmur was found on the base of the right hemithorax. There is pain [...] in the abdomen when touched at the epigastrium and right hypocondrium. The liver is perceived 3 cm beneath the costal edge: White blood count with severe eosinophilia. Mild cholestasis is observed. Abdominal scan: Heterogeneous hepatic mass, with a 13 cm diameter in the right lobe. CAT scan: Subcapsular 14x8 cm mass. Scintiscan: Liver with a low absorption area showing absence of perfusion to the vascular pool. She undergoes an exploratory laparotomy and an 800 cc subcapsular hematoma is found in segment 6, 7 and 8, which is drained. Evolution evidences the persistence of eosinophilia and positive Arc-2 is obtained for Fasciola. She was administered Triclabendazol and is currently asymptomatic. Conclusion: The invasive stage of human fascioliasis may cause hepatic hematoma as a rare complication. The triad of persisting eosinophilia, painful hepatomegalia and prolonged fever leads to insist in the search of fascioliasis in endemic areas.

David, Loja Oropeza; José, Alvizuri Escobedo; Maricela, Vilca Vásquez; Roberto, Avilés Gonzaga; Mario, Sánchez Mercado.

2003-04-01

328

Rectus Sheath Hematoma Mimicking Acute Abdominal Pain  

Directory of Open Access Journals (Sweden)

Full Text Available Abdominal sheat hematoma is a rare cause of acute abdominal disorders and may be misdiagnosed from other causes of abdominal pain. Early diagnosis is mandatory in order to avoid morbidity or unnecessary surgery. We describe a case of an 55-year-old men receiving anticoagulants who presented with typical clinical manifestations of acute surgical abdomen. A computed tomography scans demonstrated a right rectus sheath hematoma. The patient was treated conservatively with success. It is important to recognize this entity of rectus sheath hematoma among patients complaining of acute abdominal pain. [Cukurova Med J 2012; 37(4.000: 243-246

Huseyin Narci

2012-08-01

329

Serial computed tomographies in subdural effusions following purulent meningitis  

International Nuclear Information System (INIS)

The subdral effusion complicating acute purulent meningitis were visualized in seven children by means of cranial computed tomography (CCT). All these children were infants less than two years old; four were male, and three were female. The etiologic organisms could be cultured in three cases: Group B Streptococcus, Diplococcus pneumoniae, and Hemophilus influenza. The others could not be cultured. The subdural effusion could be detected by CCT on the 5th day after the onset in the earliest case and on the 30th day in the latest case. Four cases of them were resolved by chemotherapy and subdural taps, two cases were resolved spontaneously by chemotherapy only, and one case was resolved by means of a subdural-peritoneal shunt operation. The subdural taps through the anterior fontanelle were done in five cases. The fluids obtained by the subdural taps showed a bloody fluid in one case, a blood-tinged fluid in two cases, and a yellowish or brown-coloured fluid not including red cells in two cases. These fluids had a higher protein content than the CSF. These children were followed-up after the discharge. Their psychomotor development was good and they showed no epileptic complications. (author)

330

Serial MR Imaging of Intramuscular Hematoma: Experimental Study in a Rat Model with the Pathologic Correlation  

International Nuclear Information System (INIS)

We wanted to demonstrate the temporal changes of the magnetic resonance imaging (MRI) findings in experimentally-induced intramuscular hematomas in rats and to correlate these data with the concurrent pathologic observations. Intramuscular hematoma was induced in 30 rats. The MR images were obtained at 1, 4, 7 and 10 days and at 2, 3, 4, 6 and 8 weeks after muscle injury. The characteristic serial MRI findings were evaluated and the relative signal intensities were calculated. Pathologic specimens were obtained at each time point. On the T1-weighted imaging (T1WI), the intramuscular hematomas exhibited isointensity compared to that of muscle or the development of a high signal intensity (SI) rim on day one after injury. The high SI persisted until eight weeks after injury. On the T2-weighted imaging (T2WI), the hematomas showed high SI or centrally low SI on day one after injury, and mainly high SI after four days. A dark signal rim was apparent after seven days, which was indicative of hemosiderin on the pathology. The gradient echo (GRE) imaging yielded dark signal intensities at all stages. Unlike brain hematomas, experimentally-induced intramuscular hematomas show increased SI on both the T1WI and T2WI from the acute stage onward, and this is pathologically correlated with a rich blood supply and rapid healing response to injury in the muscle. On the T2WI and GRE imaging, high SI with a peripheral dark signal rim is apparent from seven days to the chronic stagent from seven days to the chronic stage

331

Rectus sheath hematoma: three case reports  

OpenAIRE

Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the ...

Kapan Selin; Turhan Ahmet N; Alis Halil; Kalayci Mustafa U; Hatipoglu Sinan; Yigitbas Hakan; Aygun Ersan

2008-01-01

332

Delayed extradural hematoma : a case report.  

Directory of Open Access Journals (Sweden)

Full Text Available Three patients of delayed extradural hematoma (EDH were seen in the last one year among forty eight consecutively treated cases of EDH. All the three hematomas were evacuated. Awareness of this entity and a high degree of vigilance are strongly recommended to detect such cases. Repeat CT should always be done, especially after decompression by either surgical or medical means, recovery from shock or whenever there is evidence of even minimal bleeding under a skull fracture on initial CT scan.

Alappat J

2002-07-01

333

Serial MR Imaging of Intramuscular Hematoma: Experimental Study in a Rat Model with the Pathologic Correlation  

Energy Technology Data Exchange (ETDEWEB)

We wanted to demonstrate the temporal changes of the magnetic resonance imaging (MRI) findings in experimentally-induced intramuscular hematomas in rats and to correlate these data with the concurrent pathologic observations. Intramuscular hematoma was induced in 30 rats. The MR images were obtained at 1, 4, 7 and 10 days and at 2, 3, 4, 6 and 8 weeks after muscle injury. The characteristic serial MRI findings were evaluated and the relative signal intensities were calculated. Pathologic specimens were obtained at each time point. On the T1-weighted imaging (T1WI), the intramuscular hematomas exhibited isointensity compared to that of muscle or the development of a high signal intensity (SI) rim on day one after injury. The high SI persisted until eight weeks after injury. On the T2-weighted imaging (T2WI), the hematomas showed high SI or centrally low SI on day one after injury, and mainly high SI after four days. A dark signal rim was apparent after seven days, which was indicative of hemosiderin on the pathology. The gradient echo (GRE) imaging yielded dark signal intensities at all stages. Unlike brain hematomas, experimentally-induced intramuscular hematomas show increased SI on both the T1WI and T2WI from the acute stage onward, and this is pathologically correlated with a rich blood supply and rapid healing response to injury in the muscle. On the T2WI and GRE imaging, high SI with a peripheral dark signal rim is apparent from seven days to the chronic stage

Lee, Yeon Soo; Kim, Jong Ok; Choi, Eun Seok [Daejeon St. Mary' s Hospital, The Catholic University of Korea, Daejeon (Korea, Republic of); Kwon, Soon Tae [Chungnam National University, School of Medicine, Daejeon (Korea, Republic of)

2011-02-15

334

Leakage of contrast into a postmeningitic subdural effusion  

International Nuclear Information System (INIS)

The CT findings in a 6-month-old boy with hemophilus influenzae meningitis, complicated by the occurrence of bilateral subdural effusions, are described. The effusions were hypodense and the contents markedly enhanced (increase of 40 Hounsfield units) after contrast injection. (orig.)

335

Evaluation of Risk Factors for Rectus Sheath Hematoma.  

Science.gov (United States)

Rectus sheath hematoma (RSH) develops due to rupture of epigastric arteries or the rectus muscle. Although RSH incidence rate is low, it poses a significant diagnostic dilemma. We evaluated the risk factors for RSH, its presentation, management, and outcomes for 115 patients hospitalized with confirmed RSH by computed tomography scan between January 2005 and June 2009. More than three-fourth (77.4%) of the patients were on anticoagulation therapy, 58.3% patients had chronic kidney disease (CKD) stage ?3, 51.3% had abdominal injections, 41.7% were on steroids/immunosuppressant therapy, 37.4% had abdominal surgery/trauma, 33.9% had cough, femoral puncture was performed in 31.3% of patients, and 29.5% were on antiplatelet therapy. Rectus sheath hematoma was not an attributable cause in any of the 17 deaths. Mortality was significantly higher in patients with CKD stage ?3 (P = .03) or who required transfusion (P = .007). Better understanding of RSH risk factors will facilitate early diagnoses and improve management. PMID:25294636

Sheth, Heena S; Kumar, Rohit; DiNella, Jeannine; Janov, Cheryl; Kaldas, Hoda; Smith, Roy E

2014-10-01

336

Intramural duodenal hematoma as a complication of therapy with Warfarin: a case report and literature review; Hematoma intramural duodenal como complicacao de terapia anticoagulante com Warfarin: relato de caso e revisao da literatura  

Energy Technology Data Exchange (ETDEWEB)

We report a case of a patient receiving chronic oral anticoagulant therapy with Warfarin who presented with acute intestinal obstruction. Computed tomography showed intramural duodenal hematoma. Treatment was conservative with correction of the coagulation parameters and observation. This case exemplifies the usefulness of conservative therapy and computed tomography in patients with acute small bowel obstruction receiving anticoagulant therapy. (author)

Faria, Juliano [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: drjuliano@uol.com.br; Pessoa, Roberta; Hudson, Marcelo; Vitoi, Silvio; Villela, Ovidio; Torres, Jose; Paula, Mara Delgado [Hospital Marcio Cunha, Ipatinga, MG (Brazil). Servico de Diagnostico por Imagem; Bemvindo, Aloisio [Hospital Marcio Cunha, Ipatinga, MG (Brazil). Servico de Terapia Intensiva

2004-12-01

337

Two faces of orbital hematoma in intranasal (endoscopic) sinus surgery.  

Science.gov (United States)

Orbital hematoma and blindness can occur during or after sinus surgery. All orbital hematomas in 3500 endoscopic sinus ethmoidectomies were identified and evaluated for type, treatment, and sequelae. Fifteen orbital hematomas were identified, with 1 case of temporary blindness and no cases of permanent blindness. Two types of orbital hematoma were identified-slow (venous) and fast (arterial)-which differ in management. The venous type results from penetration of the lamina papyracea and disruption of veins. The arterial hematoma is caused by anterior or posterior ethmoid artery injury. The treatment approach to each is different, with blindness more likely occurring from a fast (arterial) hematoma. Of the 2 types of orbital hematoma that can occur during sinus surgery, surgical decompression and hemorrhage control are more likely with the fast arterial hematoma, which has not been the subject of any prior presentation. Cause and management of each will be discussed. PMID:10352437

Stankiewicz, J A; Chow, J M

1999-06-01

338

Bilateral asynchronous acute epidural hematoma : a case report  

OpenAIRE

Abstract Background Bilateral extradural hematomas have only rarely been reported in the literature. Even rarer are cases where the hematomas develop sequentially, one after removal of the other. Among 187 cases of operated epidural hematomas during past 4 years in our hospital, we found one case of sequentially developed bilateral epidural hematoma. Case Presentation An 18-year-old conscious male worker was admitted to our hospital after a fall. After deterioration of his consciousness, an e...

Ghodsi Mohammad; Ketabchi Ebrahim; Eftekhar Behzad; Esmaeeli Babak

2003-01-01

339

Atrial Septal Hematoma after Minimally Invasive Aortic Valve Replacement  

OpenAIRE

Interatrial septal hematoma is a very rare complication after mitral valve surgery. Unusually, it is the result of aortic valve disease, including aortic dissection. We report a case wherein interatrial septal hematoma followed minimally invasive aortic valve replacement in a 68-year-old woman. The hematoma was recognized upon intraoperative transesophageal echocardiography, but there was no evidence of accompanying aortic dissection. The interatrial septal hematoma was at first drained by ne...

Biniwale, Reshma M.

2010-01-01

340

Spinal epidural hematoma; Spinales epidurales Haematom  

Energy Technology Data Exchange (ETDEWEB)

Spinal epidural hematoma is an accumulation of blood in the potential space between the dura and bone. On unenhanced computed tomography epidural hemorrhage appears as a high-density spinal canal mass with variable cord compression. Magnetic resonance imaging is the modality of choice for evaluating spinal epidural hematoma and can demonstrate the extent of the hematoma and degree of cord compression. When treated surgically the outcome depends on the extent of preoperative neurological deficits and on the operative timing interval. (orig.) [German] Das spinale epidurale Haematom ist eine Blutansammlung zwischen Dura und Knochen. Die klinische Praesentation ist aehnlich dem akuten Bandscheibenvorfall, die Symptomatik ist allerdings in der Regel progredient. In der CT stellt sich ein frisches Haematom hyperdens dar. Die MRT ist die Methode der Wahl zur Diagnose spinaler epiduraler Haematome und kann die Ausdehnung sowie auch das Ausmass der Kompression darstellen. Die wichtigste Differenzialdiagnose vom epiduralen Haematom ist das epidurale Empyem. (orig.)

Papanagiotou, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

2012-05-15

341

Delayed epidural hematoma after mild head injury  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Traumatic delayed epidural hematoma (DEH can be defined as insignificant or not seen on the initial CT scan performed after a trauma but seen on the subsequent CT scan as a “massive” epidural bleeding. Case report. We presented two cases of traumatic DEH after mild head injury. Both patients were conscious and without neurological deficit on the admission. Initial CT scan did not reveal intracranial hematoma. Repeated CT scan, that was performed after neurological deterioration, revealed epidural hematoma in both cases. The patients were operated with a favorable surgical outcome. Conclusion. Traumatic DEH could occur in the patients with head injuries who were conscious on the admission with a normal initial CT scan finding. Early detection of DEH and an urgent surgical evacuation were essential for a good outcome.

Radulovi? Danilo

2005-01-01

342

Computer tomography of intracranial tumours and hematomas  

International Nuclear Information System (INIS)

The value of computed tomography (CT) for the diagnosis of intracranial tumors and hematomas was investigated in a retrospective study comprising 220 patients. All C.T.scans are reviewed and described in detail. To assess the diagnostic accuracy, the original interpretation of the C.T.scans was compared with that of conventional neuroradiological and neurophysiological examinations. The aspect on C.T. of the various types of tumors and hematomas proved to vary widely and specific features were seldom seen. This holds particularly for the malignant tumors. Benign tumors such as meningeomas, adenomas and neurilemmomas showed a rather easily identifiable and almost identical picture of the C.T.scan, and diagnosis had to be based mainly on differences in localization. The hematomas, with the exception of the older intracerebral ones, showed the most characteristic C.T.abnormalities. (Auth.)

343

Percutaneous catheter drainage of complicated traumatic perirenal hematoma: case report  

International Nuclear Information System (INIS)

A perirenal hematoma very commonly occurs after trauma. Treatment differs according to the degree of renal injury, though many cases are managed conservatively and complications are rare. We report tow cases in which successful treatment of a perirenal hematoma involved percutaneous catheter drainage; in one there was bowel obstruction, and in the other the hematoma was infected

344

Spontaneous intramural esophageal hematoma: Case report and review  

OpenAIRE

Intramural esophageal hematoma is a rare form of esophageal injury. The presenting symptoms are nonspecific. Esophagogastroscopy and computed tomography scan are usually needed to establish the diagnosis of intramural esophageal hematoma. Presented here is a patient with spontaneous intramural esophageal hematoma who was successfully treated with conservative measures.

Cheung, Justin; Mu?ller, Nestor; Weiss, Alan

2006-01-01

345

Atypical CT findings of acute epidural hematomas  

International Nuclear Information System (INIS)

One of the classic CT findings is characterized by a lenticular high density in acute epidural hematomas. However, several atypical CT findings in acute epidural hematomas have been reported lately. We have ourselves met three cases of acute epidural hematomas, in which there were low-or isodensity spots within typical high-density areas. Case 1: a 74-year-old male, a victim of a traffic accident, showing a high degree of anemia (Ht: 14%, Hb: 2.8 g/dl.) secondary to massive subcutaneous hemorrhage resulting from traumatic DIC. His CT, taken 12 hours after the head injury, disclosed bubble-like low density spots in a typical high-density area. Case 2: a 9-month-old baby boy, who had fallen to the ground from a height of 25 cm, was also anemic on admission (Ht: 17%, Hb: 5.2 g/dl.). An initial CT-scan, 7 hours after head injury, again disclosed a huge low density spot in the center of a typical high-density area. Case 3: an 11-year-old girl, involved in a car accident. A CT-scan, taken 4.5 hours after head injury, showed a low-density spot in the center of a high-density area. In her case, however, there was no evidence of significant anemia. In these three cases, the CT findings were close to one another in appearance, namely, classic lenticular high-density areas, spotted with round low-or isodensity areas within those hematomas. The causative factors have been thought be one of the following: a markedly low hemoglobin value, a time difference in the coagulation proces time difference in the coagulation process within the same hematomas, or a possible leakage of CSF into the hematomas from a dural tear. It seemed that no single causative factor was responsible in these three cases; rather, it seems that multiple factors had progressed simultaneously. (author)

346

Concurrent Intracranial and Spinal Subdural Hematoma in a Teenage Athlete: A Case Report of This Rare Entity  

OpenAIRE

A 15-year-old male high school football player presented with episodes of headache and complete body stiffness, especially in the arms, lower back, and thighs, immediately following a football game. This was accompanied by severe nausea and vomiting for several days. Viral meningitis was suspected by the primary clinician, and treatment with corticosteroids was initiated. Over the next several weeks, there was gradual symptom improvement and the patient returned to his baseline clinical statu...

Treister, Daniel S.; Kingston, Sara E.; Gabriel Zada; Manu Singh; Jones, Jesse G. A.; Mills, Jena N.; Alexander Lerner; Boyko, Orest B.; Meng Law; Anandh Rajamohan; Shiroishi, Mark S.

2014-01-01

347

Postoperative epidural hematoma. Five cases of epidural hematomas developed after supratentorial craniotomy on the contralateral side  

Energy Technology Data Exchange (ETDEWEB)

Postoperative epidural hematomas developed far from the operative field are generally recognized as a complication of ventriculo-peritoneal shunt, ventricular drainage or suboccipital craniotomy. It is very rare but may occur after supratentorial craniotomy on the contralateral side. Five such cases are presented with a review of the relevant literature. The mechanism of this complication is not clearly understood. In hydrocephalus, these massive epidural hematomas are probably caused by dura-skull detachment when the brain volume is strikingly reduced by a decompressive procedure. On rare occasions, pins of head rest may detach the dura and cause epidural hematomas. When sudden brain swelling during craniotomy is encountered, attention should be directed not only to intracerebral hemorrhage but also epidural hematoma developed on the contralateral side.

Sato, M. (Shiga Univ. of Medical Science, Ohtsu (Japan)); Mori, K.; Handa, H.

1981-10-01

348

Bilateral isodense epidural hematoma: case report Hematoma epidural isodenso bilateral: relato de caso  

OpenAIRE

We present a case of a severe head injuried 23 year-old male patient. The initial CT scan disclosed bilateral epidural hematoma, isodense with the brain, thus being a pitfall in diagnosis. Brief case report, image and literature rewiew are presented.Apresentamos o caso de um homem de 23 anos com traumatismo craniano grave. A TC de crânio demonstrou um volumoso hematoma epidural bilateral, isodenso com o cérebro, sendo uma armadilha ao diagnóstico. São apresentados um breve relato, estudo ...

Rodrigo Mendonça; Lima, Telmo T. F.; Dini, Leandro I.; Krebs, Cla?udio L. L.

2005-01-01

349

Spontaneous rectus sheath hematoma during rivaroxaban therapy  

Science.gov (United States)

Rivaroxaban is an oral anticoagulant agent that directly inhibits Factor Xa and interrupts both the intrinsic and extrinsic pathway of the coagulation cascade and is currently indicated for use in patients for atrial fibrillation and prophylaxis of deep venous thrombosis. The present case reports of spontaneous rectus sheath hematoma during rivaroxaban therapy for atrial fibrillation in a 75-year-old woman. PMID:24987185

Kocayigit, Ibrahim; Can, Yusuf; Sahinkus, Salih; Ayd?n, Ercan; Vatan, Mehmet Bulent; K?l?c, Harun; Gunduz, Huseyin

2014-01-01

350

Spontaneous rectus sheath hematoma during rivaroxaban therapy  

OpenAIRE

Rivaroxaban is an oral anticoagulant agent that directly inhibits Factor Xa and interrupts both the intrinsic and extrinsic pathway of the coagulation cascade and is currently indicated for use in patients for atrial fibrillation and prophylaxis of deep venous thrombosis. The present case reports of spontaneous rectus sheath hematoma during rivaroxaban therapy for atrial fibrillation in a 75-year-old woman.

Kocayigit, Ibrahim; Can, Yusuf; Sahinkus, Salih; Ayd?n, Ercan; Vatan, Mehmet Bulent; K?l?c, Harun; Gunduz, Huseyin

2014-01-01

351

Intramural hematoma of colon having traumatic origin  

International Nuclear Information System (INIS)

The author presents a case of intramural hematoma of colon having traumatic origin, which triggered intestinal occlusion and was successfully treated though a right hemicolectomy.This is a rare form of anatomo clinical traumatic affectation of colon.The importance of CAT scan in its diagnosis and treatment planning should be highlighted

352

Study of near infrared technology for intracranial hematoma detection  

Science.gov (United States)

Although intracranial hematoma detection only requires the continuous wave technique of near infrared spectroscopy (NIRS), previous studies have shown that there are still some problems in obtaining very accurate, reliable hematoma detection. Several of the most important limitations of NIR technology for hematoma detection such as the dynamic range of detection, hair absorption, optical contact, layered structure of the head, and depth of detection are reported in this article. A pulsed light source of variable intensity was designed and studied in order to overcome hair absorption and to increase the dynamic range and depth of detection. An adaptive elastic optical probe was made to improve the optical contact and decrease contact noise. A new microcontroller operated portable hematoma detector was developed. Due to the layered structure of the human head, simulation on a layered medium was analyzed experimentally. Model inhomogeneity tests and animal hematoma tests showed the effectiveness of the improved hematoma detector for intracranial hematoma detection.

Zhang, Quan; Ma, Hong Y.; Nioka, Shoko; Chance, Britton

2000-04-01

353

Groin hematoma after electrophysiological procedures-incidence and predisposing factors  

DEFF Research Database (Denmark)

Abstract Objectives. We evaluated the incidence and predisposing factors of groin hematomas after electrophysiological (EP) procedures. Design. Prospective, observational study, enrolling consecutive patients after EP procedures (Atrial fibrillation: n = 151; Supraventricular tachycardia/Diagnostic EP: n = 82; Ventricular tachycardia: n = 18). Patients underwent manual compression for 10 min and 3 h post procedural bed rest. AF ablations were performed with INR 2-3, ACT > 300, and no protamine sulfate. Adhesive pressure dressings (APDs) were used if sheath size ? 10F; procedural time > 120 min; and BMI > 30. Patient-reported hematomas were recorded by a telephone follow-up after 2 weeks. Results. Hematoma developed immediately in 26 patients (10%) and after 14 days significant hematoma was reported in 68 patients (27%). Regression analysis on sex, age, BMI 25, ACT 300, use of APD, sheath size and number, and complicated venous access was not associated with hematoma, either immediately after the procedure or after 14 days. Any hematoma presenting immediately after procedures was associated with patient-reported hematomas after 14 days, odds ratio 18.7 (CI 95%: 5.00-69.8; P < 0.001). Conclusions. Any hematoma immediately after EP procedures was the sole predictor of patient-reported hematoma after 2 weeks. Initiatives to prevent groin hematoma should focus on the procedure itself as well as post-procedural care.

Dalsgaard, Anja Borgen; Jakobsen, Christina Spåbæk

2014-01-01

354

An ultrasonographic study of experimental hematoma in rabbit  

International Nuclear Information System (INIS)

Sequenctial ultrasonography was performed after induction of vitreous hematoma in 24 rabbits eyeball to analyze the characteristic sonographic findings of resorbing hematoma. Ultrasonography was done at immediate after inducing hematoma and were followed up at 2nd day, 1st week, 2nd week and 4th week. The result were as follows; 1. In immediate scan after inducing hematoma, multiple sheet-like or linear shaped hematoma was more common than round or diffuse shaped. 2. Size of hematoma was decreased from 2nd day, much more at l1st week, and nearly or completely absorbed at 4th week. 3. Margin of hematoma was blurred from 2nd day and rapidly changed afterward. 4. Even though echogenecity of hematoma in immediate B-mode scan after inducing hematoma showed largely less echogenic than that of retro-orbital fat, hyperechoic and isoechoic cases were also seen. 5. Reflectivity of hematoma, till 2nd day, showed largely over 50% of that of retro-orbital fat, but decreased to the level of below 50%at 1st week, and nearly or completely absorbed at 4th week

355

MR imaging of epidural hematoma in the lumbar spine  

International Nuclear Information System (INIS)

To bring attention to the MR imaging appearance of epidural hematoma (EDH) in the lumbar spine as a small mass often associated with disk herniation or an acute event. This paper will show our experience with this entity and describe criteria for its MR imaging appearance. Design and patients. Thirteen cases of prospectively diagnosed EDH of the lumbar spine were compared with 12 cases of prospectively diagnosed prominent epidural extrusion. Our criteria were retrospectively evaluated by the two authors for their presence or absence in each case. The chi-square test for nominal data was applied. MR imaging criteria utilized to distinguish EDH from disk herniation at our institution include: (1) signal different from disk, (2) high signal on T1-weighted images, either centrally or peripherally, (3) teardrop- or egg-shaped mass, in the sagittal plane, (4) size greater than half the vertebral body height in a craniocaudal dimension, (5) primarily retrosomatic epidural location, (6) plasticity - the mass is seen to conform closely to the contours of bone (e.g., in the lateral recess), (7) little or no disk space narrowing unless associated with disc herniation. Chi-square analysis demonstrated each criterion to significantly differentiate between EDH and extrusion. Only six of 13 EDH cases went to surgery in spite of their relatively large size. Two of six patients were diagnosed as having epidural clot consistent with hematoma at the time of surgery. The four patients wh the time of surgery. The four patients who were not diagnosed at surgery revealed only small disk herniations or fragments of disk. The occurrence of EDH is more frequent than previously suspected. Spontaneous EDH is frequently associated with disk herniation and acute events such as sneezing or coughing. Most cases of spontaneous EDH will resolve prior to surgery with only the minority becoming chronic in order to be seen at surgery as an encapsulated mass. MR imaging can reliably identify EDH and distinguish between EDH and large disk extrusions. (orig.)

356

Hematomas espontáneos de la pared abdominal Spontaneous Hematomas of the abdominal wall  

Directory of Open Access Journals (Sweden)

Full Text Available Introducción: El hematoma espontáneo de la pared abdominal (HEPA es una entidad de aparición infrecuente y de difícil diagnóstico debido a la similitud clínica con otros procesos agudos. Suele aparecer en pacientes que siguen tratamiento anticoagulante y se caracteriza por su forma de presentación brusca como dolor abdominal agudo. La cirugía puede evitarse en la mayoría de los casos si se diagnostica correctamente mediante pruebas de imagen. Observaciones clínicas: Presentamos 12 casos de HEPA tratados en nuestro Servicio entre los años 1999 y 2005, y realizamos una revisión de esta entidad en cuanto a etiología, factores desencadenantes, diagnóstico y tratamiento. Conclusión: El tratamiento del HEPA debe ser conservador, reservando la cirugía para aquellos casos que presenten deterioro hemodinámico por sangrado activoIntroduction: Spontaneous hematoma of the abdominal wall is infrequent and difficult to diagnose due to its clinical similarity with other acute processes. It is usually associated with patients undergoing anticoagulant therapy and is characterized for its form of abrupt presentation like acute abdominal pain. Surgery can be avoided in most patients if hematoma is correctly diagnosed by imaging tests. Clinical observations: We present 12 cases of spontaneous hematoma of the abdominal wall from 1999 through 2005 and we review the etiology, precipitating factors, diagnosis and treatment of this clinical entity. Conclusion: Treatment of spontaneous hematoma of abdominal wall must be preservative, reserving the surgery for those cases that present hemodynamic compromise by persistent hemorrhage

Rafael Cerdán P

2007-02-01

357

Hematomas espontáneos de la pared abdominal / Spontaneous Hematomas of the abdominal wall  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Introducción: El hematoma espontáneo de la pared abdominal (HEPA) es una entidad de aparición infrecuente y de difícil diagnóstico debido a la similitud clínica con otros procesos agudos. Suele aparecer en pacientes que siguen tratamiento anticoagulante y se caracteriza por su forma de presentación [...] brusca como dolor abdominal agudo. La cirugía puede evitarse en la mayoría de los casos si se diagnostica correctamente mediante pruebas de imagen. Observaciones clínicas: Presentamos 12 casos de HEPA tratados en nuestro Servicio entre los años 1999 y 2005, y realizamos una revisión de esta entidad en cuanto a etiología, factores desencadenantes, diagnóstico y tratamiento. Conclusión: El tratamiento del HEPA debe ser conservador, reservando la cirugía para aquellos casos que presenten deterioro hemodinámico por sangrado activo Abstract in english Introduction: Spontaneous hematoma of the abdominal wall is infrequent and difficult to diagnose due to its clinical similarity with other acute processes. It is usually associated with patients undergoing anticoagulant therapy and is characterized for its form of abrupt presentation like acute abdo [...] minal pain. Surgery can be avoided in most patients if hematoma is correctly diagnosed by imaging tests. Clinical observations: We present 12 cases of spontaneous hematoma of the abdominal wall from 1999 through 2005 and we review the etiology, precipitating factors, diagnosis and treatment of this clinical entity. Conclusion: Treatment of spontaneous hematoma of abdominal wall must be preservative, reserving the surgery for those cases that present hemodynamic compromise by persistent hemorrhage

Rafael, Cerdán P; Sandra, Paterna L; María Eugenia, Guillén S; Sonia, Cantín B; Joaquín, Bernal J; Jesús María, Esarte M.

2007-02-01

358

Spontaneous intraneural hematoma of the sural nerve.  

Science.gov (United States)

Symptomatic intraneural hemorrhage occurs rarely. It presents with pain and/or weakness in the distribution following the anatomic innervation pattern of the involved nerve. When a purely sensory nerve is affected, the symptoms can be subtle. We present a previously healthy 36-year-old female who developed an atraumatic, spontaneous intraneural hematoma of her sural nerve. Sural dysfunction was elicited from the patient's history and physical examination. The diagnosis was confirmed with magnetic resonance imaging, and surgical decompression provided successful resolution of her preoperative symptoms. To our knowledge, this entity has not been reported previously. Our case highlights the importance of having a high index of suspicion for nerve injury or compression in patients whose complaints follow a typical peripheral nerve distribution. Prior studies have shown that the formation of intraneural hematoma and associated compression of nerve fibers result in axonal degeneration, and surgical decompression decreases axonal degeneration and aids functional recovery. PMID:25311865

Richardson, Shawn S; McLawhorn, Alexander S; Mintz, Douglas N; DiCarlo, Edward F; Weiland, Andrew J

2015-04-01

359

Ultrasonographic findings of psoas abscess and hematoma  

International Nuclear Information System (INIS)

A retrospective analysis of the ultrasonographic findings of 9 cases tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 cases of highly echogenic mass-like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent, and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma

360

A new treatment for hypertensive intracerebral hematoma  

International Nuclear Information System (INIS)

Durining the last 2 years, 46 cases of hypertensive intracerebral hemorrhage in the basal ganglia were treated by CT guided stereotactic aspiration and their outcome was evaluated in terms of the rate of hematoma removal, the change of consciousness level and the recovery of motor and sensory functions. They are aged from 45 to 79 years old, the average 56, and aspirated 1 to 24 days after the onset, two third of them being within 1 week. The whole procedure was done in the CT room under direct CT guidance and by one trial. In putaminal type hemorrhage, the removed hematoma volumes ranged from 9 to 48 ml, average being 23.7 ml, in thalamic type from 5 to 29 ml, average being 15.5 ml. The average rate of removal was 81.1 % in 30 cases within 1 week. In most cases, preoperative consciousness was not severely disturbed, in putaminal type, 19 were alert or confused, 4 somnolent, 5 stuperous and in thalamic type, 6, 6, 3 respectively and 2 were semicomatous, one of them had herniation sign. In putaminal type all but 2 cases recovered to alert or confused state, the first one had postoperative bleeding and the other was already apallic preoperatively. In thalamic type, we lost 3 cases, 2 by gastrointestinal bleeding and 1 DIC, by rehemorrhage 2 months after the operation. All but one who was semicomatous preoperatively recovered to alertness. In motor function, some cases of the putaminal bleeding with intact internal capsule remained hemiplegic. On the other hand, most of the cases with partial destruction of the internal capsule on CT recovered well in both types of hematoma. Especially in thalamic type, only 2 had inability to walk durinig the follow-up period. In sensory function, two thirds of the cases recovered to almost normal level. CT guided stereotactic aspiration, therefore, can be evaluated as less invasive and more definitive treatment for intracerebral hematoma in the basal ganglia. (author)

361

Thyroid Gland Hematoma After Blunt Neck Trauma  

OpenAIRE

Hemorrhage of a previously normal thyroid gland as a result of blunt trauma is a very rare condition. We report a case of blunt trauma that caused acute hemorrhage into the thyroid gland and presented with hoarseness. The diagnosis of thyroid gland hematoma was made with a combination of fiberoptic laryngoscopy, cervical computed tomography, and carotid angiography. The patient was treated conservatively, had a favorable course without further complications, and was discharged four days after...

Saylam, Baris; Comcali, Bulent; Ozer, Mehmet Vasfi; Coskun, Faruk

2009-01-01

362

Cough-induced internal oblique hematoma  

OpenAIRE

Violent or sustained cough can be associated with serious musculoskeletal complications. We report a case of a cough-induced internal oblique hematoma in an obese 73-year-old woman who was not receiving antithrombotic therapy. She had no history of trauma and presented with acute worsening pain in the right flank. She had been coughing continuously for the past month and had severe cough 2 days before the onset of pain. Ultrasonography revealed a hypoechoic mass in the right lateral abdominal...

Kodama, Koichi; Takase, Yasukazu; Yamamoto, Hiroki; Noda, Toru

2013-01-01

363

CORRELACIÓN CLÍNICO-TOMOGRÁFICA DEL HEMATOMA INTRAPARENQUIMATOSO  

Directory of Open Access Journals (Sweden)

Full Text Available Se realizó un estudio transversal descriptivo a todos los pacientes con diagnóstico clínico y tomográfico de hematoma intraparenquimatoso espontáneo egresados de la Unidad de Cuidados Intermedios del Hospital Provincial Clínico Quirúrgico Docente ¿Manuel Ascunce Domenech¿ de Camagüey desde el 1ro de marzo de 2002 hasta el 28 de febrero de 2003, con el objetivo de correlacionar clínica e imagenológicamente los enfermos diagnosticados con hematoma intraparenquimatoso espontáneo. Esta dolencia fue más frecuente en hombres que en mujeres, en pacientes blancos y mayores de 60 años. Los antecedentes más frecuentes fueron la hipertensión arterial en el 86.5 %, seguidos por la enfermedad vascular isquémica y diferentes cardiopatías. Al 70.6 % de los pacientes no se le diagnosticó la enfermedad en el Servicio de Urgencia; la tomografía computarizada resultó útil en el diagnóstico y topografía en el 100 %; mientras que el estudio clínico permitió llegar al diagnóstico positivo en el 92.3 % y al topográfico en el 80.5 % de los pacientes. El método clínico y el estudio tomográfico del hematoma intraparenquimatoso fueron útiles en el diagnóstico y localización, y dentro de ellos los más frecuentes fueron las labores, putaminales y talámicos.

Eugenio de Zayas Alba

2004-01-01

364

An obscure case of hepatic subcapsular hematoma.  

Science.gov (United States)

Spontaneous liver bleeding is often reported in preeclampsia. It is otherwise rare and has been linked to gross anatomical lesions and coagulopathy. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy. A 41-year-old male, paraplegic for 16 years, presented to the emergency department 3 days after sudden onset of right upper quadrant and shoulder pain. He had been on vitamins and 5,000 units subcutaneous heparin 12-hourly at the nursing home for the last month. He was in no distress, afebrile, with stable vitals. Physical examination showed a diverting colostomy, tender hepatomegaly and sacral decubiti. A fecal occult blood test was negative. There was spastic paraplegia below the level of T12. Two days after admission, the patient was afebrile and hemodynamically stable. PTT, PT, liver profile, BUN and creatinine were all normal, however his hemoglobin had dropped from 11.3 to 7.6 g/dl. An abdominal CT scan revealed an isolated 9.0 × 1.8 cm subcapsular hematoma. The patient received blood transfusion in the intensive care unit and was discharged 7 days later. In conclusion, spontaneous liver hemorrhage occurs in the nonobstetrical population in the setting of gross anatomical lesions or coagulopathy. This is the first report of an isolated subcapsular liver hematoma. PMID:21552450

Ndzengue, Albert; Hammoudeh, Fadi; Brutus, Pierre; Ajah, Ofem; Purcell, Roland; Leadon, Joseph; Rafal, Richard B; Balmir, Simon; Enriquez, Danilo A; Posner, Gerald L; Jaffe, Eric A; Chandra, Pradeep

2011-01-01

365

Langerhans' cell histiocytosis presenting with an intracranial epidural hematoma  

International Nuclear Information System (INIS)

An 8-year-old boy developed vomiting and severe headache following minor head trauma. A CT scan of the head demonstrated a lytic lesion of the skull and adjacent epidural hematoma. Surgical evacuation and removal of the skull lesion and hematoma were carried out, and pathologic evaluation resulted in a diagnosis of Langerhans' cell histiocytosis (LCH). Epidural involvement of Langerhans' cell histiocytosis is very rare, and we report the first case of LCH presenting as an intracranial epidural hematoma. (orig.)

366

Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood  

OpenAIRE

Acute epidural hematoma is a critical emergency all around the world, and its aggressive diagnosis and treatment are of vital importance. Emergent surgical evacuation of the hematoma is known as standard management; however, conservative procedures are also used for small ones. Spontaneous rapid resolution of these hematomas has also been reported in eight pediatric cases. Various theories have been proposed to explain the underlying pathophysiology of this resolution. Herein, we are reportin...

En, Ismail G. Xfc L. X. F.; Hakan Ak; Xfc Nc Xfc, Enver S. Xf S.; Alpaslan Yavuz; Nejmi Kiymaz

2013-01-01

367

Gastric intramural hematoma: A case report and literature review  

OpenAIRE

Intramural hematoma of the gastrointestinal tract is an uncommon occurrence, with the majority being localized to the esophagus or duodenum. Hematoma of the gastric wall is very rare, and has been described most commonly in association with coagulopathy, peptic ulcer disease, trauma, and amyloid-associated microaneurysms. A case of massive gastric intramural hematoma, secondary to anticoagulation therapy, and a gastric ulcer that was successfully managed with conservative therapy, is presente...

Dhawan, Vivek; Mohamed, Ahmed; Fedorak, Richard N.

2009-01-01

368

Differentiated surgical treatment of patients with hypertensive intracerebral hematomas  

OpenAIRE

Hypertensive intracerebral hematoma is one of the most severe forms of cerebrovascular pathology, characterized by high lethality and disability. One of the objectives in providing assistance remains the development of new minimally invasive methods for the removal of hematomas. We have analyzed the results of surgical treatment of 176 patients with intracerebral hematoma. Patients from the 1st group were done open craniotomy. Patients from the 2nd group were performed the external ventricula...

Natalia Ivanova; Valery Bersnev; Istam Agzamov; Mansur Agzamov

2011-01-01

369

Bilateral Rectus Sheath Hematoma in Kidney Transplant Patient: Case Study and Literature Review  

OpenAIRE

Rectus sheath hematoma usually occurs unilateral but rare cases of bilateral hematoma have been reported. Herein we report the first case of spontaneous bilateral Rectus Sheath Hematoma in the kidney transplanted patient.

Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

2013-01-01

370

77 FR 16925 - Medical Devices; Neurological Devices; Classification of the Near Infrared Brain Hematoma Detector  

Science.gov (United States)

...Classification of the Near Infrared Brain Hematoma Detector AGENCY: Food and Drug Administration...Near Infrared (NIR) Brain Hematoma Detector into class II (special controls...Near Infrared (NIR) Brain Hematoma Detector, and it is identified as a...

2012-03-23

371

Sonographic diagnosis of intramural hematoma of gastrointestinal tract  

International Nuclear Information System (INIS)

Sonographic findings of nine cases of intramural hematoma of the gastrointestinal tract are presented. The duodenum was the most common site, followed by the ascending colon and the stomach. Intramural hematomas present as centrally or eccentrically located bowel mass of variable echogenicity: heter-ogeneously echogenic in six cases; hypoechoic in two case; anechoic in one case. In five cases of duodenal hematoma, the stomach and/or duodenal bulb were distended and filled with fluid. It is concluded that ultrasonography is a simple and useful tool in the diagnosis of intramural hematoma of the intestine

372

The study of hematomas in 500 consecutive face lifts.  

Science.gov (United States)

Our incidence of hematoma in 500 consecutive face lifts was 2.6 percent, of which 1.6 percent were severe enough to need evacuation. This incidence of hematoma correlated well with the blood pressures of patients on admission; when the pressure was above 150/100 mm Hg on admission, hematoma occurred 2.6 times more frequently than in normotensive patients. Our premedication regime and hypotensive therapy was effective in reducing preoperative hypertension to normotensive levels in most, but not all, patients. However, this reduction of the postoperative blood pressure to normal levels did not prevent hematoma formation entirely. PMID:850705

Straith, R E; Raju, D R; Hipps, C J

1977-05-01

373

CT-guided stereotaxic evacuation of cerebellar hematoma  

International Nuclear Information System (INIS)

Stereotaxic lateral approach for cerebellar hematoma is presented using Leksell's CT-stereotaxic system. All of the procedures are performed in the CT room. Patient's head is turned to contralateral side of the hematoma 30 to 400 with slight flexion of the neck. Stereotaxic apparatus is secured to the head under local anesthesia. Hematoma is confirmed by computerized tomograms. Three dimensional coordinates of the target point (center of the hematoma) are measured from the vertical and diagonal rods of Leksell's system. Linear skin incision 4 cm in length is made on retromastoid area. Burr-hole is put on just lateral position of the target point, usually 5 to 6 cm posterior and 1 cm above from the external auditory meatus. Transverse or sigmoid sinus does not appeared through the burr-hole by this approach. Specially made Dandy's cannula (3.0 mm in diameter, 220 mm in length) is inserted into the target point, and manual evacuation of the hematoma is performed carefully using a syringe. Then Dandy's cannula is replaced by silastic drainage tube (3.5 mm in diameter), and 6,000 Units of Urokinase solved in 2 ml of saline is administered to the hematoma cavity. Dissolved hematoma is aspirated every 24 hours until the most of the hematoma is evacuated. We operated three cases of cerebellar hematoma by this method with favorable results. Advantages of this method are as follows: Operative invasion is minimal; The surgeon can cbeck the residual hematoma and posit can cbeck the residual hematoma and position of the tip of cannula even at operation, if necessary. (author)

374

Unsuspected organic disease in chronic schizophrenia demonstrated by computed tomography  

International Nuclear Information System (INIS)

Unsuspected intracranial pathology was demonstrated in 12 of 136 chronic schizophrenic patients examined by computed tomography (CT). Seven cases of cerebral infarction were found, and one each of porencephalic cyst, meningioma, cystic enlargement of the pineal body, and two of subdural haematoma. Attention is drawn to the value of CT in demonstrating organic disease in schizophrenia. (author)

375

Precedence of Parenchymal Enhancement on CT Angiography to a Fatal Duret Hemorrhage  

OpenAIRE

We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of ...

Sim, Ki-bum; Na, Dong Gyu; Park, Ji Kang

2013-01-01

376

Vertex epidural hematoma neuroradiological findings and management. A case report  

International Nuclear Information System (INIS)

Epidural hematomas occurring at the vertex are uncommon, and they can be difficult to diagnose by axial CT. We report a case of acute traumatic vertex epidural hematoma, which resolved spontaneously with time. We stress the importance of MR investigations in this diagnostic challenge

377

Treatment of acute traumatic epidural hematoma in infancy and childhood  

International Nuclear Information System (INIS)

The authors treated 22 cases of epidural hematoma diagnosed by CT scan. This study focused on the analysis of the time-course and development of epidural hematoma using a CT scan. The results are follows: 1. Severe cases must be treated by craniotomy and rapid removal of hematoma. We achieved a zero mortality rate in the cases of infants and children. 2. Normal CT findings were not unusual in cases where the patient was examined within 3 hours after the occurence of the injury. Conservative treatment was indicated for patients with a small amount of epidural hematoma. CT scanning at intervals of 6 hours and 30 hours after the occurence of the injury offer the best correlation in regard to the course of hematoma. 3. Operative treatment is required when the hematoma thickness, measured by CT scan, is more than 20 mm for infants and younger children or 30 mm for school aged children. However, eventhough the thickness of the hematoma maybe less than these guidelines, when progressive deterioration occurs after the CT scan, operative treatment must be considered. 4. Diffuse brain injury is a new clinical entity found by CT scanning. We classified this into 5 types. Of the 5 types, ''diffuse cerebral swelling'' was observed in the initial CT scan of two patients, however, epidural hematoma developed afterwards. Thus, patients with diffuse cerebral swelling with a skull fracture must be closely observed. (J.P.N.)

378

Cocaine-Induced Intramural Hematoma of the Ascending Aorta  

OpenAIRE

We report the case of a 35-year-old man who presented at our institution with intramural aortic hematoma shortly after inhaling cocaine and smoking crack cocaine. To our knowledge, such a case has not previously been reported in the English medical literature. Problems of diagnosis and the mechanisms of intramural hematoma and aortic dissection are discussed.

Neri, Eugenio; Toscano, Thomas; Massetti, Massimo; Capannini, Gianni; Frati, Giacomo; Sassi, Carlo

2001-01-01

379

Subcapsular hematoma of the liver in a neonate: case report  

Energy Technology Data Exchange (ETDEWEB)

Subcapsular hematoma of the liver in the neonate is an uncommon clinical presentation, although these tumors are frequently found upon perinatal autopsy. We describe the sonographic and MR findings of a subcapsular hematoma of the liver in a neonate having a clinical history of an inserted umbilical venous catheter, necrotizing enterocolitis and sepsis, and we also include a review of the relevant literature.

Im, Soo Ah; Lim, Gye Yeon [The Catholic University of Korea, Seoul (Korea, Republic of)

2005-07-15

380

Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage  

International Nuclear Information System (INIS)

Intraventricular hemorrhage following intraparenchymatous hematoma is thought to be a frequent and often fatal event. Computerized tomography has proved to be valuable for their diagnosis. Hospital records of seventy-eight patients with intraparenchymatous hematoma and intraventricular hemorrhage diagnosed by computerized tomography were retrospectively reviewed to evaluate initial clinical features and CT findings in order to assess potential prognostic factors. (orig.)

381

Prognostic factors in intraparenchymatous hematoma with ventricular hemorrhage  

Energy Technology Data Exchange (ETDEWEB)

Intraventricular hemorrhage following intraparenchymatous hematoma is thought to be a frequent and often fatal event. Computerized tomography has proved to be valuable for their diagnosis. Hospital records of seventy-eight patients with intraparenchymatous hematoma and intraventricular hemorrhage diagnosed by computerized tomography were retrospectively reviewed to evaluate initial clinical features and CT findings in order to assess potential prognostic factors. (orig.).

Ruscalleda, J.; Peiro, A.

1986-01-01

382

Thyroid Gland Hematoma After Blunt Neck Trauma  

Directory of Open Access Journals (Sweden)

Full Text Available Hemorrhage of a previously normal thyroid gland as a result of blunt trauma is a very rare condition. We report a case of blunt trauma that caused acute hemorrhage into the thyroid gland and presented with hoarseness. The diagnosis of thyroid gland hematoma was made with a combination of fiberoptic laryngoscopy, cervical computed tomography, and carotid angiography. The patient was treated conservatively, had a favorable course without further complications, and was discharged four days after admission.[West J Emerg Med. 2009;10(4:247-249.

Saylam, Baris

2009-11-01

383

Contrast of artificial subcutaneous hematomas in MRI over time.  

Science.gov (United States)

In clinical forensic medicine, hematomas and other externally visible injuries build the basis for the reconstruction of events. However, dating of subcutaneous hematomas based on their external aspect is difficult. Magnetic resonance imaging (MRI) has proven its use in dating intracranial hemorrhage. Thus, the aim was to investigate if MRI can also be used for dating subcutaneous hematomas and to analyze an eventual influence of the hematoma shape. In 20 healthy volunteers (11 females, 9 males, aged 26.9?±?3.8 years), 4 ml of autologous blood were injected subcutaneously in the thigh. The hematoma was scanned immediately after the injection, after 3 and 24 h and 3, 7, and 14 days using three sequences with different contrast. Data was analyzed by measuring signal intensities of the hematoma, the muscle, and the subcutaneous tissue over time, and the Michelson contrast coefficients between the tissues were calculated. In the analysis, hematoma shape was considered. Signal intensity of blood in the proton density-weighted sequence reached its maximum 3 h after the injection with a subsequent decrease, whereas the signal intensities of muscle and fatty tissue remained constant. The time course of the Michelson coefficient of blood versus muscle decreased exponentially with a change from hyperintensity to hypointensity at 116.9 h, depending on hematoma shape. In the other sequences, either variability was large or contrast coefficients stayed constant over time. The observed change of contrast of blood versus muscle permits a quick estimate of a hematoma's age. The consideration of the hematoma shape is expected to further enhance dating using MRI. PMID:25416961

Hassler, Eva Maria; Ogris, Kathrin; Petrovic, Andreas; Neumayer, Bernhard; Widek, Thomas; Yen, Kathrin; Scheurer, Eva

2015-03-01

384

Hematoma intraventricular como complicação de meningite purulenta: relato de caso Intraventricular hematoma as a meningitis complication: case report  

OpenAIRE

Relato de caso de rara complicação de meningite purulenta, ou seja, hematoma intraventricular não associado a malformação vascular ou septação ventricular que justificassem a não difusão do sangue.Report of a case of intraventricular hematoma as purulent meningitis complication in a child of 6 months old, without vascular malformation. The evolution was sactisfatory after the surgical treatment.

Pedro Garcia Lopes; Wanderley, Eliana C. F. O.; Lamartine Correa de Moraes Junior; Wander Tamburus

1985-01-01

385

Hematoma epidural espinal espontâneo durante a gravidez: registro de um caso Spontaneous epidural spinal hematoma during pregnancy: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Registro de caso de paciente no oitavo mês de gestação que desenvolveu hematoma epidural espinal espontâneo dorsolombar. A gravidez, determinando aumento da pressão intra-abdominal e, como consequência, aumento da pressão venosa no plexo epidural, poderia ter sido o fator desencadeante no hematoma- A paciente foi submetida a cirurgia precocemente, porém não apresentou recuperação do déficit sensitivo-motor. São discutidos aspectos clínicos, do tratamento cirúrgico, da evolução e da etiologia dos hematomas epidurals espinais espontâneos.A case of spontaneous dorso-lombar spinal epidural hematoma during pregnancy is reported. The hematoma was removed 8 hours after the onset of paraplegia, and there was no evidence of vascular malformation. The motor deficit remained unchanged post-operatively. The etiology, clinical findings and the value of early laminectomy are discussed.

Ivan Hack

1984-03-01

386

Hematoma epidural espinal espontâneo durante a gravidez: registro de um caso / Spontaneous epidural spinal hematoma during pregnancy: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Registro de caso de paciente no oitavo mês de gestação que desenvolveu hematoma epidural espinal espontâneo dorsolombar. A gravidez, determinando aumento da pressão intra-abdominal e, como consequência, aumento da pressão venosa no plexo epidural, poderia ter sido o fator desencadeante no hematoma- [...] A paciente foi submetida a cirurgia precocemente, porém não apresentou recuperação do déficit sensitivo-motor. São discutidos aspectos clínicos, do tratamento cirúrgico, da evolução e da etiologia dos hematomas epidurals espinais espontâneos. Abstract in english A case of spontaneous dorso-lombar spinal epidural hematoma during pregnancy is reported. The hematoma was removed 8 hours after the onset of paraplegia, and there was no evidence of vascular malformation. The motor deficit remained unchanged post-operatively. The etiology, clinical findings and the [...] value of early laminectomy are discussed.

Ivan, Hack; Mario S., Cademartori; Rosendo S., Mamani; Carmen M., Beltrame; Carlos G., Cademartori.

1984-03-01

387

Spontaneous subperiosteal hematoma precipitated by anxiety attack.  

Science.gov (United States)

A 60-year-old woman presented with diplopia and left periorbital edema and pressure, which developed during an anxiety attack the previous day. Examination revealed left inferotemporal globe dystopia, periorbital edema, ecchymosis, and limitation in supraduction. Orbital MRI confirmed the diagnosis of a superior subperiosteal orbital hematoma. The patient's signs and symptoms rapidly resolved with administration of oral corticosteroids. The patient remains asymptomatic with complete resolution of orbital signs at 3-month follow-up. Subperiosteal orbital hematoma (SOH) is a rare condition in which blood accumulates between the bony orbit and separated periosteum, and is often due to blunt head trauma. Non-traumatic SOH (NTSOH) is exceedingly rare and usually associated with known coagulopathies or tendency to bleed. However, few cases of spontaneous NTSOH have been reported without any such predisposition and are thought to be caused by sudden elevations in intrathoracic and intracranial venous pressure such as vomiting, coughing, SCUBA diving, weight lifting and labor. We herein describe the presentation, radiography and outcome of a unique case of spontaneous NTSOH following an anxiety attack. PMID:24063522

Swanenberg, Irene M; Rizzuti, Allison E; Shinder, Roman

2013-12-01

388

Multiple subdural abscesses following colonic perforation - a rare complication of a ventriculoperitoneal shunt  

International Nuclear Information System (INIS)

A case of colonic perforation by a ventriculoperitoneal shunt, its subsequent migration and protrusion from the anal orifice is reported. The shunt reservoir and ventricular catheter were removed percutaneously, and the disconnected peritoneal catheter was pulled out through the anus. Blood culture grew Klebsiella pneumoniae and Streptococcus fecalis. CT scan showed multiple subdural abscesses with evidence of ventriculitis. Removal of the shunt (as described), evacuation of subdural pus and systemic antibiotics resulted in complete recovery. (orig.)

389

Effects of chronic ingestion of tritiated water on prenatal brain development  

International Nuclear Information System (INIS)

In view of the anticipated increased use of atomic energy in industry, the possible long-term effects of chronic radiation exposure were studied in five generations of rats. Female rats (F0) were given tritiated drinking water (3HOH;3?Ci/ml) from adolescence (60 days) until and throughout pregnancy. A separate study showed that the maximum radioactivity in the urine is reached in 30 days, and in the blood in 42 days. In the newborns, the highest specific activity was in the nucleic acid fraction, but total radioactivity was mainly due to the water (body fluids) compartment. No signs of radiation illness or increase in cataract formation in the mothers were observed. The food and water intake and body weight changes before pregnancy were normal. The course and the outcome of pregnancy were also normal. However, 60% of the newborns (F1) exhibited hematomas, edemas, and subdural hemorrhages, which disappeared at 30 days of age. Bollod analysis of the F1 offspring at various ages did not reveal significant differences from the controls, except for a significant decrease in alkaline phosphatase. Newborn body weight and cerebral weight were also normal. On the other hand, cerebral DNA, protein, and protein/DNA were significantly lower. 3HOH administration was then continued throughout weaning, adolescence, and next pregnancies, to give F3, F4, and F5 generations. The newborns in F3sub> generations. The newborns in F3--F5 showed no more cerebral damage than those in F1, i.e., there was no cumulative effect of radiation; presumably the maximum radioactivity level was already attained in F1. As the generations progressed, the radiation damage to the developing brain became less pronounced; a possibility of inducible DNA repair has been discussed

390

Hematoma cerebelar espontâneo: análise de 23 casos Spontaneous cerebellar hematoma: analysis of 23 cases  

Directory of Open Access Journals (Sweden)

Full Text Available Uma série de 23 pacientes com hematoma espontâneo de cerebelo é analisada retrospectivamente, mostrando que: todos apresentavam algum grau de diminuição do nível de consciência e cefaléia; 12 apresentavam déficits motores dentre os sinais clínicos mais importantes. Dos antecedentes patológicos destacam-se hipertensão arterial (69,5% e diabetes (34%, havendo associação de ambos em 30% dos casos. Dos aspectos da tomografia computadorizada (TC mais relevantes a dilatação ventricular aguda, encontrada em 69,5% dos pacientes, associada ou não a presença de sangue intraventricular, é considerada sinal de mau prognóstico, indicando por si só terapêutica de urgência. A melhor abordagem cirúrgica para a maioria desses casos é a drenagem ventricular externa de urgência, reservando a craniectomia da fossa posterior para esvaziamento do hematoma para casos específicos. A mortalidade e a morbidade desta patologia é alta; porém, pela TC o diagnóstico se tornou mais rápido e eficiente. Os pacientes desta série puderam beneficiar-se deste procedimento, como se verifica quando comparados a pacientes de outras séries, diagnosticados por outros métodos.A series of 23 patients with spontaneous cerebellar hematoma is analysed retrospectively. Several degrees of conciousness impairment, and headache occurred in all; 12 patients presented motor deficits among the more important clinical signs. Arterial hypertension (69,5% and diabetes (34% stand out in the pathological background, and their association was frequent (30%. Computerized tomography (CT disclosing severe ventricular dilatation (69.5% associated or not with intraventricular presence of blood is considered as an unsactisfatory prognosis sign, and indicative for emergency therapy. Emergency external ventricular draining is the best indication for the majority of these cases. Posterior fossa craniectomy for emptying the hematoma may be the indication in severe cases. Death and morbidity in this pathology are high as yet. However, CT contribution for diagnosis is quicker and better than benefits obtained through other methods. Results observed in the present series are illustrative on this statement, when compared to data of other series diagnosed through other methods.

J. P. Rial

1988-03-01

391

Optoacoustic detection of intra- and extracranial hematomas in rats after blast injury  

OpenAIRE

Surgical drainage of intracranial hematomas is often required within the first four hours after traumatic brain injury (TBI) to avoid death or severe disability. Although CT and MRI permit hematoma diagnosis, they can be used only at a major health-care facility. This delays hematoma diagnosis and therapy. We proposed to use an optoacoustic technique for rapid, noninvasive diagnosis of hematomas. In this study we developed a near-infrared OPO-based optoacoustic system for hematoma diagnosis a...

Petrov, Andrey; Wynne, Karon E.; Parsley, Margaret A.; Petrov, Irene Y.; Petrov, Yuriy; Ruppert, Katherine A.; Prough, Donald S.; Dewitt, Douglas S.; Esenaliev, Rinat O.

2014-01-01

392

CD36-Mediated Hematoma Absorption following Intracerebral Hemorrhage: Negative Regulation by TLR4 Signaling  

OpenAIRE

Promoting hematoma absorption is a novel therapeutic strategy for intracerebral hemorrhage (ICH); however, the mechanism of hematoma absorption is unclear. The present study explored the function and potential mechanism of CD36 in hematoma absorption using in vitro and in vivo ICH models. Hematoma absorption in CD36-deficient ICH patients was examined. Compared with patients with normal CD36 expression, CD36-deficient ICH patients had slower hematoma adsorption and aggravated neurologic defic...

Fang, Huang; Chen, Jing; Lin, Sen; Wang, Pengfei; Wang, Yanchun; Xiong, Xiaoyi; Yang, Qingwu

2014-01-01

393

Baker's Cyst Filled with Hematoma at the Lower Calf.  

Science.gov (United States)

Baker's cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Baker's cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Baker's cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Baker's cyst have not been reported in Korea. We report a rare case of hematoma in the Baker's cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision. PMID:25505709

Yoo, Moon-Jib; Yoo, Jae-Sung; Jang, Ho-Seong; Hwang, Chang-Hwan

2014-12-01

394

Dabigatran-related Intracerebral Hemorrhage Resulting in Hematoma Expansion  

DEFF Research Database (Denmark)

Warfarin-related intracerebral hemorrhage carries a particularly high risk of neurologic deterioration and death because of a high rate of hematoma expansion of about 50%. Novel oral anticoagulants (NOACs)-apixaban, dabigatran, and rivaroxaban-have a significantly smaller risk of intracerebral hemorrhage (ICH). However, two facts make this situation complicated: First, the risk of hematoma expansion is unknown for NOACs. Second, there is no specific antidote for neither of the NOACs. We present a case that suggests that hematoma expansion may occur after NOAC-related ICH.

Simonsen, Claus Z; Steiner, Thorsten

2014-01-01

395

A case of rectus sheath hematoma caused by yoga exercise.  

Science.gov (United States)

Rectus sheath hematoma is a relatively rare condition but a significant cause of acute abdominal pain. The acute abdominal pain associated with rectus sheath hematoma can mimic several conditions, such as appendicitis, intestinal problems (obstruction, perforation, hernia, malignancy), and gynecologic disease (ovarian cyst, torsion, tubo-ovarian abscess, ectopic pregnancy). Correct diagnosis and subsequent treatment depends on careful history taking and appropriate use of diagnostic tools to avoid unnecessary laparotomy. We report a case of rectus sheath hematoma due to noncontact strenuous exercise, yoga, that mimicked gynecologic diseases. PMID:19683130

Choi, Yoonhee; Lee, Donghoon

2009-09-01

396

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report  

International Nuclear Information System (INIS)

Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

397

Spontaneously Developed Pulmonary Arterial Intramural Hematoma That Mimicked Thromboembolism  

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A 65-year-old woman visited our hospital with a complaint of acute onset dyspnea and radiological manifestations of pulmonary thromboembolism. The patient underwent an exploratory surgery to find a whitish-blue colored mass occupying almost the whole lumen of the main pulmonary arteries. Based on the pathological and radiological findings, the patient was diagnosed to have a pulmonary arterial intramural hematoma. Intramural hematomas are usually observed in the walls of the aorta, and we believe that an isolated intramural hematoma in the pulmonary artery has not been described previously.

Kang, Eun Ju; Lee, Ki Nam [Dong-A University College of Medicine, Busan (Korea, Republic of); Kim, In; Chane, Jong Min; Kim, Gun Jik; Yang, Dong Heon; Lee, Jong Min [Kyungpook National University Hospital, Daegu (Korea, Republic of)

2012-07-15

398

MRI of spinal hematoma as a result of lumbar puncture  

International Nuclear Information System (INIS)

A 59-year-old woman was suspected of having meningitis. A lumbar puncture was performed for CSF analysis; however, a traumatic tap induced hemorrhage in the subarachnoid space and formed a hematoma from the L3 to the S1 level. This resulted in a paraparesis. Myelography showed a band-like filling defect and a subsequent computed tomography (CT) myelogram showed a soft tissue mass in the intradural space. T1 weighted magnetic resonance imaging revealed a lesion with moderate hyperintensity within the dural sac, hinting that the lesion was a hematoma. Laminectomy was performed, and the hematoma was entirely removed. (orig.)

399

Spontaneous ligamentum flavum hematoma in the lumbar spine  

International Nuclear Information System (INIS)

Lumbar or sacral nerve root compression is most commonly caused by intervertebral disc degeneration and/or herniation. Less frequently, other extradural causes may be implicated, such as infection, neoplasm, epidural hematoma, or ligamentum flavum pathology. We present the case of a patient with spontaneous ligamentum flavum hematoma compressing the L4 nerve root, without antecedent trauma. Although exceedingly rare, the diagnosis of ligamentum flavum pathology in general, and that of ligamentum flavum hematoma in particular, should be considered on those rare occasions when the etiology of lumbar or sacral nerve root compressions appears enigmatic on radiological studies. Usually surgical treatment produces excellent clinical outcome. (orig.)

400

Spontaneous ligamentum flavum hematoma in the lumbar spine  

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Lumbar or sacral nerve root compression is most commonly caused by intervertebral disc degeneration and/or herniation. Less frequently, other extradural causes may be implicated, such as infection, neoplasm, epidural hematoma, or ligamentum flavum pathology. We present the case of a patient with spontaneous ligamentum flavum hematoma compressing the L4 nerve root, without antecedent trauma. Although exceedingly rare, the diagnosis of ligamentum flavum pathology in general, and that of ligamentum flavum hematoma in particular, should be considered on those rare occasions when the etiology of lumbar or sacral nerve root compressions appears enigmatic on radiological studies. Usually surgical treatment produces excellent clinical outcome. (orig.)

Keynan, Ory; Ashkenazi, Ely; Floman, Yizhar [Israel Spine Center at Assuta Hospital, Tel Aviv (Israel); Smorgick, Yossi [Israel Spine Center at Assuta Hospital, Tel Aviv (Israel); Assaf Harofeh Medical Center, Department of Orthopedic Surgery, Zerifin (Israel); Schwartz, Allan J. [Hadassah University Hospital, Department of Radiology, Section of Neuroradiology, Jerusalem (Israel)

2006-09-15

401

Giant Chest Wall Hematoma Mimicking Elastofibroma Dorsi: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Hematoma on the thoracic wall is very rare. We describe here a 63-year-old man with a huge chest wall hematoma and the man had no history of trauma. The patient was found to have a large mass located subjacent to the inferior angle of the right scapula area and the CT and MRI findings were similar to those of an elastofibroma dorsi. We describe the CT and MRI findings of this hematoma and how to make the differential diagnosis from elastofibroma dorsi

Lee, Yeon Soo; Park, Kuhn; Kim, Jong Ok; Choi, Eun Seok; Kang, Si Won [Daejeon St. Mary' s Hospital, The Catholic University of Korea, Daejeon (Korea, Republic of)

2011-02-15

402

Extensive retroperitoneal hematoma in blunt trauma  

International Nuclear Information System (INIS)

To report our experience of managing extensive retroperitoneal hematoma (RH) in patients with blunt trauma and to determine any associated factors affecting causation and mortality. In this retrospective observational study, patients diagnosed with extensive RH following blunt trauma admitted to King Saud Medical Complex, Riyadh, Kingdom of Saudi Arabia between January 2004 and December 2009 were included. Patient data were explored for injury severity score (ISS), associated injuries, location of hematoma, amount of blood transfusions, coagulation profile, operative management, hospital stay, and mortality. The outcomes in surviving and non-surviving patients were compared. Out of 290 patients presenting with RH, extensive RH was found in 46 patients (15.8%). The overall mortality was 32.6%. The pelvis was the most frequent location of RH in combination with lateral and central zones (65.2%). The lower extremity and pelvic fractures were the most common injury. Associated intra-peritoneal injuries were present in 39.1% patients. An exploratory laparotomy was performed in 58.7% patients (n=27). A high ISS (55.9 versus 35.5, p<0.0001), abnormal coagulation profile (odds ratio [OR] 7.8, 95% confidence interval [CI] 1.974-30.932, p=0.005, and associated chest injuries OR 5.94, 95% CI 1.528-23.19, p=0.014) were independent factors associated with mortality. Multiple musculoskeletal injuries in addition to intra-abdominal injuries and abnormal coagulation are major factorsand abnormal coagulation are major factors associated with the presence of extensive RH. High ISS, abnormal coagulation, and associated chest injuries are independent factors associated with mortality (Author).

403

Spontaneous epidural hematoma at lumbar facet joint: a case report  

International Nuclear Information System (INIS)

Spontaneous epidural hematomas (SEHs) of the lumbar spine are rare. The pathogenesis is not entirely clear, but several reports have suggested that bleeding originating in the venous epidural plexus is the cause. This is the second report of a SEH thought to be the result of facet joint hemorrhage with no previous synovial cyst formation. A magnetic resonance image revealed a mass beginning in the left epidural space and continuing through to the left L5-S1 facet joint. Surgically, the epidural hematoma, which was covered by a very thin translucent membrane, was visualized directly. A histopathological examination revealed the wall of the epidural hematoma to be composed of very thin fibrous connective tissue with no synovium lining. The purpose of this study was to report a case of an epidural hematoma originated from lumbar facet joint, diagnosed by radiological examination, and to present a review of the subject literature

404

Hand-held instrument should relieve hematoma pressure  

Science.gov (United States)

Portable instrument relieves hematomas beneath fingernails and toenails without surgery. This device simplifies the operative procedure with an instant variable heating tip, adjustable depth settings and interchangeable tip sizes for cauterizing small areas and relieving pressurized clots.

Raggio, L. J.; Robertson, T. L.

1967-01-01

405

Differentiated surgical treatment of patients with hypertensive intracerebral hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available Hypertensive intracerebral hematoma is one of the most severe forms of cerebrovascular pathology, characterized by high lethality and disability. One of the objectives in providing assistance remains the development of new minimally invasive methods for the removal of hematomas. We have analyzed the results of surgical treatment of 176 patients with intracerebral hematoma. Patients from the 1st group were done open craniotomy. Patients from the 2nd group were performed the external ventricular drainage, also needle aspiration with fibrinolysis. Patients from the 3rd group were performed minimally invasive removal using the original device. Results of treatment were evaluated using Glasgow outcome scale. Lethality was observed in 1st group in 47.8% of cases, in 2nd group in 31.8%, in 3rd group in 29.7%. Minimally invasive technique reduced the postoperative mortality and improved treatment outcomes of patients with intracerebral hematoma.

Natalia Ivanova

2011-04-01

406

Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours  

International Nuclear Information System (INIS)

In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection o in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

407

Calf hematoma - computed tomographic and magnetic resonance findings  

International Nuclear Information System (INIS)

Four patients with hematomas of the calf are presented. The diagnosis was made by computed tomography (CT) in three cases and CT/magnetic resonance imaging (MRI) in one case. In all cases, CT or MRI clarified a confusing clinical picture. CT and MRI can help differentiate the types of calf mass (i.e., hematoma, tumor, Baker cyst, thrombophlebitis) and assist proper clinical management in a rapid, noninvasive fashion. (orig.)

408

Unilateral proptosis and extradural hematoma in a child with scurvy  

International Nuclear Information System (INIS)

We report a 3-year-old boy with unilateral proptosis, painful swelling of the right thigh and aphasia. He had radiographic evidence of scurvy in the limbs and bilateral frontal extradural hematomas with a mass lesion in the left orbit on MRI. He was treated with vitamin C and on follow-up 8 weeks later had recovered with no evidence of the orbital mass on clinical or radiological study. Scurvy manifesting as proptosis and extradural hematoma is rare. (orig.)

409

Muscle hematoma: A critically important complication of alcoholic liver cirrhosis  

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Full Text Available An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy. Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare. We herein, present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis, and review the literature on muscle hematoma associated with cirrhosis. A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemia. The cause of anemia could not be detected, and the patient was treated conservatively. The site of bleeding was not detected with either gastroduodenal endoscopy or upper abdominal computed tomography, the latter of which did not include the iliopsoas muscle. He died on the 10th day of admission and bilateral iliopsoas hematomas were found on autopsy. An iron stain was positive in the iliopsoas muscle. Eight cases of muscle hematoma associated with cirrhosis, including the present case, were found in a review of the literature. Four of these cases involved the rectus abdominis muscle, 3 involved the iliopsoas muscle and 1 involved combined muscles. Alcoholic cirrhosis accounted for 75% of the cases. One case (12.5% was associated with virus-related cirrhosis, and another with combined virus- and alcohol-related cirrhosis. The mortality rate was 75% despite early diagnosis and low risk scores for cirrhosis. Muscle hematoma in patients with cirrhosis is closely related to alcoholism, and the mortality rate of the condition is extremely high. In conclusion, muscle hematoma should be recognized as an important complication of cirrhosis.

Chiyo Sugiyama, Akifumi Akai, Noriyoshi Yamakita, Tsuneko Ikeda, Keigo Yasuda

2009-09-01

410

A life threatening problem in infants: supratentorial epidural hematoma  

OpenAIRE

Traumatic epidural hematoma (EDH) represents a rare head injury complication in infants.Its diagnosis can be quite challenging because its clinical presentation is usually subtle and nonspecific.Authors present a study on 30 infants with epidural hematoma (EDH) admitted in the Pediatric Department of Neurosurgery of the ‘Bagdasar–Arseni’ Clinical Hospital in the period of 1990–2007 (17 years).The most common symptom was irritability, which occurred in 16 cases (53.3%), of ...

Ciurea, Av; Tascu, A.; Brehar, Fm; Nuteanu, L.; Rizea, R.

2009-01-01

411

Unilateral proptosis and extradural hematoma in a child with scurvy  

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We report a 3-year-old boy with unilateral proptosis, painful swelling of the right thigh and aphasia. He had radiographic evidence of scurvy in the limbs and bilateral frontal extradural hematomas with a mass lesion in the left orbit on MRI. He was treated with vitamin C and on follow-up 8 weeks later had recovered with no evidence of the orbital mass on clinical or radiological study. Scurvy manifesting as proptosis and extradural hematoma is rare. (orig.)

Verma, Sumit; Sivanandan, Sindhu; Seth, Rachna; Kabra, Shushil [All India Institute of Medical Sciences (AIIMS), Department of Pediatrics, New Delhi (India); Aneesh, Mangalasseril K.; Gupta, Vaibhav [All India Institute of Medical Sciences (AIIMS), Department of Radiodiagnosis, New Delhi (India)

2007-09-15

412

Small supratentorial, extraaxial primitive neuroectodermal tumor causing large intracerebral hematoma  

OpenAIRE

A 16-year-old boy presented with an unusual case of a supratentorial, extraaxial small round blue cell tumor of the central nervous system, which was most likely a primitive neuroectodermal tumor (PNET). Preoperative computed tomography and magnetic resonance imaging showed a large multistage hematoma in the left central region. Intraoperatively, a small, superficial tumorous lesion was found between the sagittal sinus and a large cortical vein hidden by the hematoma. The histological diagnos...

Burkhardt, J. K.; Kockro, R. A.; Dohmen-scheufler, H.; Woernle, C. M.; Bellut, D.; Kollias, S. S.; Bertalanffy, H.

2011-01-01

413

[Hypovolemic shock during surgery caused by a rectus sheath hematoma].  

Science.gov (United States)

Prophylactic treatment with low molecular weight heparins (LMWH) is currently widely used to prevent thromboembolic events. However, such treatment is not free of risk. Among the possible complications described is rectus sheath hematoma. We report the case of a patient undergoing surgery for a hypophysial adenoma approached by the transsphenoidal route. He received LMWH prophylaxis for thromboembolism and showed a tendency to hypotension during surgery. The patient's condition deteriorated to hypovolemic shock accompanied by episodes of atrial fibrillation with rapid ventricular response. With the transfusion of medications, blood products and plasma volume expanders, the patient was stabilized and surgery was completed. A computed tomography scan then revealed a hematoma occupying the greater part of the left anterior rectus muscle. With conservative wait-and-see treatment the abdominal symptoms disappeared and the hematoma gradually receded until fully resolved. Spontaneous rectus sheath hematoma is a rare condition. Presentation is quite nonspecific and computed tomography is needed for reaching a firm diagnosis. When a hematoma is large, the initial clinical picture may include hypovolemic shock, which may develop during surgery if the hematoma is not diagnosed early. Intraoperative management will be much more difficult than it would have been if diagnosis and treatment had taken place before the operation. PMID:16281745

Vidal, M A; López-Escobar, M; Medina, C; García, R; Torres, L M

2005-10-01

414

MRI evaluation of postoperative epidural hematoma after lumbar spine surgery  

International Nuclear Information System (INIS)

Pain or numbness in the lower extremities often persists after lumbar spine surgery and it is not rare for such symptoms to occur anew. We performed a retrospective comparative study in 66 cases to determine whether there were differences in post-operative symptoms based on the presence of an epidural hematoma diagnosed by postoperative MRI. An epidural hematoma was identified in 30 of the cases, but not in the other 36 cases. The incidence of buttocks pain was 40.0% in the epidural hematoma group (EH group), as opposed to 16.7% among those without an epidural hematoma (non-EH group), and the difference between the two groups was significant (P=0.034). The incidence of pain in the lower extremities was 40.0% in the EH group, as opposed to 16.7% in the non-EH group, and the difference between the two groups was significant (P=0.034). However, there were no difference between the groups in low back pain, lower extremity numbness, presence of muscular weakness, or rate of improvement in Japanese Orthopedic Association (JOA) score. All of the postoperative hematomas resolved spontaneously. The result of the study showed that some epidural hematomas cause postoperative symptoms to persist and make the short-term outcome unsatisfactory even through the long-term results are ultimately satisfactory. (author)

415

The MR imaging findings in spontaneous spinal epidural hematoma  

International Nuclear Information System (INIS)

Objective: To evaluate MR findings and clinical features in patients with spontaneous spinal epidural hematoma (SSEH). Methods: Eight patients (5 men, 3 women; aged 16 - 50 years) with SSEH underwent MR imaging during 1994 - 2001, including 7 cases without history of trauma or coagulation disorders and 1 case with history of hypertension. MR imaging was performed from 4 hours to 3 days after the onset of symptoms in all 8 patients with surgical and pathologic diagnosis. Results: The hematomas were in lateral posterior or posterior epidural space, including 3 cases in cervical vertebra, 2 cases in thoracic vertebra, 2 cases in cervical and thoracic junction region, and 1 case in thoracic and lumbar part. The MRI confirmed an encapsulated hematoma caused by arteriovenous malformation in 1 case and two hematomas associated with disc herniation. The signal intensity of the hematoma varied with the hematoma age, but T1-weighted images reflected its typical signal changes. Sagittal and coronal T1-weighted images revealed isointense (7 cases) and slight high-intense (1 case) signal; Sagittal and axial T2-weighted images revealed mixed-intensity (6 cases) and mixed high-intensity (2 cases). Conclusion: MR imaging has an important value on localization, identification, and differential diagnosis of the lesion, therefore, it is the most helpful diagnostic tool for this condition

416

CT finding of right retroperitoneal space : analysis of extension of right perirenal hematoma  

International Nuclear Information System (INIS)

To understand the structure and character of the right retroperitoneal space by analysis of the extension of retroperitoneal hematoma in patients with traumatic right renal injuries. We retrospectively reviewed CT scans of 13 patients with right retroperitoneal hematomas caused by right renal injury. At te renal level, we analyzed the relation of a hematoma contacting psoas muscle with other retroperitoneal compartmental hematomas. At the suprarenal level, a perirenal hematoma and a hematoma contacting the diaphragm were analyzed according to their relation with intrahepatic IVC and pericaval hematoma. Below renal hilar level, all hematomas contacting psoas muscle, observed in eight cases, were connected with retrorenal extension of anterior pararenal hematoma. At the suprarenal level, intrahepatic pericaval hematomas were not, in all 13 cases, connected with a hematoma contacting the diaphragm, but with a perirenal hematoma. At the upper suprarenal level, the only pericaval hematomas containing a medial component of perirenal hematoma extended superiorly to the upper one third of the tenth thoracic vertebral body. The anterior renal fascia envelops perirenal space except in its medial aspect. In the upper suprarenal region, the anterior and posterior planes of the anterior renal fascia unite to fuse with diaphragmatic fascia, but along the medial aspect they fuse with intrahepatic pericaval connective tissue and posteromedial diaphragm, respectively diaphragm, respectively

417

Age determination of vessel wall hematoma in spontaneous cervical artery dissection: A multi-sequence 3T Cardiovascular Magnetic resonance study  

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Full Text Available Abstract Background Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR in determining the age of vessel wall hematoma (VWH in patients with spontaneous cervical artery dissection (sCAD. Methods 35 consecutive patients (mean age 43.6 ± 9.8 years with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images. Results The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p Conclusions Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.

Habs Maximilian

2011-11-01

418

Subacute phase treatment of subperiosteal hematoma of the orbit with epidural hematoma in the frontal cranial fossa: Case report  

OpenAIRE

Abstract Background Subperiosteal hematoma of the orbit is one of the rare lesions that cause exophthalmos after craniomaxillofacial trauma. Presently, there is no consensus for how to treat this disease. Although some reports have suggested a conservative type of therapy, others have recommended surgical treatments be done during the early stages. Case presentation This case report provides details on the clinical course of a 9-year-old girl with subperiosteal hematoma of the orbit. In this ...

Mikami Taro; Maegawa Jiro; Kuroda Mayu; Yamamoto Yasushi; Yasumura Kazunori

2012-01-01

419

Clinical appraisal of stereotactic hematoma aspiration surgery for hypertensive thalamic hemorrhage; With respect to volume of the hematoma  

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Three hundred and four patients with hypertensive thalamic hemorrhage were managed by medical treatment, ventricular drainage, or CT-controlled stereotactic aspiration surgery (AS). The therapeutic results of the 6-month outcome were analyzed and correlated with the volume of the hematoma. A hematoma volume of 20 ml was thought to be the critical size in determining whether the outcome would be favorable or unfavorable. Indications for AS are suggested as follows. In patients with a small-sized hematoma having a volume of less than 10 ml use of AS should be restricted to patients with severe paralysis or other neurological complications and the elderly (aged 70 years or older). For patients with a medium-sized hematoma having a volume between 10 ml and 20 ml, AS is indicated for patients having severe paralysis and disturbances of consciousness. For patients with a large-sized hematoma having a volume of 20 ml or more, AS increases not only the survival rate of patients but also reduces the number of bedridden patients. We conclude that AS opens up a new avenue of surgical treatment for hypertensive thalamic hemorrhage, which has been no indication for hematoma evacuation by conventional craniotomy. (author).

Sasaki, Koji; Matsumoto, Keizo (Tokushima Univ. (Japan). School of Medicine)

1992-06-01

420

Hematoma cerebelar espontâneo: análise de 23 casos / Spontaneous cerebellar hematoma: analysis of 23 cases  

Scientific Electronic Library Online (English)

Full Text Available Uma série de 23 pacientes com hematoma espontâneo de cerebelo é analisada retrospectivamente, mostrando que: todos apresentavam algum grau de diminuição do nível de consciência e cefaléia; 12 apresentavam déficits motores dentre os sinais clínicos mais importantes. Dos antecedentes patológicos desta [...] cam-se hipertensão arterial (69,5%) e diabetes (34%), havendo associação de ambos em 30% dos casos. Dos aspectos da tomografia computadorizada (TC) mais relevantes a dilatação ventricular aguda, encontrada em 69,5% dos pacientes, associada ou não a presença de sangue intraventricular, é considerada sinal de mau prognóstico, indicando por si só terapêutica de urgência. A melhor abordagem cirúrgica para a maioria desses casos é a drenagem ventricular externa de urgência, reservando a craniectomia da fossa posterior para esvaziamento do hematoma para casos específicos. A mortalidade e a morbidade desta patologia é alta; porém, pela TC o diagnóstico se tornou mais rápido e eficiente. Os pacientes desta série puderam beneficiar-se deste procedimento, como se verifica quando comparados a pacientes de outras séries, diagnosticados por outros métodos. Abstract in english A series of 23 patients with spontaneous cerebellar hematoma is analysed retrospectively. Several degrees of conciousness impairment, and headache occurred in all; 12 patients presented motor deficits among the more important clinical signs. Arterial hypertension (69,5%) and diabetes (34%) stand out [...] in the pathological background, and their association was frequent (30%). Computerized tomography (CT) disclosing severe ventricular dilatation (69.5%) associated or not with intraventricular presence of blood is considered as an unsactisfatory prognosis sign, and indicative for emergency therapy. Emergency external ventricular draining is the best indication for the majority of these cases. Posterior fossa craniectomy for emptying the hematoma may be the indication in severe cases. Death and morbidity in this pathology are high as yet. However, CT contribution for diagnosis is quicker and better than benefits obtained through other methods. Results observed in the present series are illustrative on this statement, when compared to data of other series diagnosed through other methods.

J. P., Rial; J., Vilalta; J.M., Guitart; E., Rúbio.

1988-03-01