Acute epidural haematomas (AEDH) are quite rare entity in geriatric age group as the dura adheres firmly to the inner table of the cranial bone. Falls due to the accompanying diseases are the main cause of traumatic brain injuries (TBIs) in older adults. Traffic accidents and assaults are the other causes. Presentation may range widely from normal mental status to severe intracerebral injury in the elderly although acute deterioration may occur in previously conscious patients. There are only a few studies in the literature concerning acute epidural haematomas in geriatric age group. In our study we reviewed 106 adult patients who were operated in Ondokuz Mayıs University School of Medicine at Department of Neurosurgery due to the AEDH between the years of 2005-2009. As there is only one patient at the geriatric age in this group ,we considered to present it as a case report reviewing the literature.
This experimental study was planned to evaluate the success of rabbit hemilaminotomy procedure and proposing of a new grading system in the evaluation of epidural fibrosis. Fourteen New Zealand white rabbits were used in this experiment. Hemilaminotomy was performed in one level and 4 weeks later after operation rabbits were sacrificied. The lumbar spines were removed and immersed in 10% neutral buffered formalin for approximately 24 hours. Then each specimen was decalcified in 5% formic acid for approximately 3 weeks. Specimens were cut coronally for gross inspection. We proposed a new grading system in the evaluation of peridural fibrosis. In seven (50%) of the rabbits of hemilaminotomy sites, fibrous tissue penetrated into the spinal canal through the bone defect and produced neural compression with reaching to the posterior longitudinal ligament (Grade IV). Four hemilaminotomy sites were in Grade III fibrosis. Remaining 3 rabbits had Grade II fibrosis. In this experimental study, we modified the rabbit total laminectomy model by using of hemilaminotomy procedure in the studying of peridural scar formation. In the same time we proposed a new grading system in the evaluation of epidural scar tissue formation.
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