An atypical case of head trauma with late onset of contrecoup epidural hematoma, cerebellar contusion, and cerebral infarction in the territory of the recurrent artery of Heubner

Sato, Shinsuke; Mitsuyama, Tetsuryu; Ishii, Akira; Kawamata, Takakazu

doi:10.1016/j.jocn.2008.08.023

Cited by 7 publications

(7 citation statements)

References 29 publications

(50 reference statements)

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“…1 The clinical-radiologic features of all the 11 cases including this case are summarized in ►Table 1. [4][5][6][7][8][9][10][11][12] The mechanism of contrecoup EDH remains unclear. Dural separation and dural vessel injury caused by distortion of the cranium brought on by the force of impact are possible mechanisms that could contribute to the development of EDH.…”

Section: Discussionmentioning

confidence: 99%

Contrecoup Acute Epidural Hematoma—A Rare Case Report

Banga

Sandeep

Dixit

et al. 2017

IJNT

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Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the dural membrane. Contact-related skull deformation causes inbending or fracturing of cranium or both, leading to separation of the dura mater from inner table. This injures the dural arteries, veins, venous sinus, or diploid channels, producing EDH. They usually occur as a result of direct impact injuries to the head, ipsilateral to impact side. Incidence of epidural hematoma is 1 to 3% of all head injuries. Contrecoup EDH cases are rare. and because of its rarity, we present a case report of a 17-year-old boy with contrecoup EDH who sustained head injury due to road traffic accident. Computed tomography of the brain showed left occipital bone fracture and large contrecoup extradural hematoma in right frontal region associated with pneumocephalus and hemorrhagic contusional edema beneath it. The EDH was operated on, and the patient was discharged uneventfully.

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Section: Discussionmentioning

confidence: 99%

Contrecoup Acute Epidural Hematoma—A Rare Case Report

Banga

Sandeep

Dixit

et al. 2017

IJNT

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“…It is hypothesized that she had an acute epidural hematoma caused by contrecoup head injury by falling backwards off a couch. Epidural hematomas of this nature are rare [12] and may develop without a fracture, because of the increased plasticity of children's bones. The injury causes a separation of the periosteal dura from the calvarium and rupture of the interposed vessels [12] .…”

Section: Discussionmentioning

confidence: 99%

“…Epidural hematomas of this nature are rare [12] and may develop without a fracture, because of the increased plasticity of children's bones. The injury causes a separation of the periosteal dura from the calvarium and rupture of the interposed vessels [12] . We speculate that this hematoma became purulent with pathogens seeded from the sinusitis noted on the admit neuroimaging studies or from hematological spread from the UTI.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Parasagittal Epidural Abscess: Another Consideration for the Etiology of Acute Headache and Fever Following a Minor Head Injury

Chen¹

2015

ijnbd

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A previously healthy seven-year-old girl, who suffered a minor head injury, experienced diagnostic complications spanning two weeks, resulting from an intracranial epidural abscess. Originally diagnosed with cephalgia and a urinary tract infection, which were unresponsive to antibiotics, secondary workup revealed a large bifrontal epidural lesion. She was transferred to our neurosurgery services for further management and workup of the lesion. Magnetic resonance imaging demonstrated an enhancing anterior parasagittal fluid collection that was suggestive of an infection. Burr-hole surgery directly over the lesion confirmed the diagnosis of brain abscess. Irrigation and drainage was done, and her recovery was rapid and uncomplicated with the subsequent treatment with appropriate antibiotics. A possible etiology for this unusually located abscess is that the patient had a hemorrhage into this location from the initial injury. This subsequently became infected after a urinary tract infection or sinusitis. This case may be a useful reference for identifying patients with a brain abscess after a minor head injury, this occurring without direct invasion of the region of concern with a known foreign body, the usual mechanism after a traumatic brain injury.

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“…These movements pose a risk of contra-coup injury to the frontal lobe, which contains the frontal eye fields. 5 In addition, a range of brainstem traumas have been described as a result of the hyperextension injuries seen in whiplash; these include lesions to the abducens and vestibulocochlear nuclei, located in the pons, and paramedian midbrain syndrome, which is an oculomotor nerve palsy. 6 …”

Section: Introductionmentioning

confidence: 99%

Persistent pseudomyopia following a whiplash injury in a previously emmetropic woman

Hughes

Treacy

Mullaney

2017

American Journal of Ophthalmology Case Reports

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PurposeAccommodative spasm, which manifests as ciliary muscle spasm, convergent strabismus or miosis, is a recognised consequence of head trauma. In whiplash cases, cervical spine hyperextension poses a risk of contra-coup injury and brainstem trauma, and is known to affect the visual system. However, to date, no cases of accommodative spasm due to whiplash injury have been reported.ObservationsWe present the case of a 34-year-old female who developed sudden onset blurred distance vision after a rear impact car crash, having previously been emmetropic. Her unaided distance visual acuity was 20/70 in the right eye and 20/20 in the left. Best-corrected visual acuity in the right eye was 20/20 with a correction that progressed from −1.75 to −3.50 DS over the 12 months following the accident.This patient's sudden unilateral myopia, with unilaterally increased amplitude of accommodation suggests pseudomyopia due to accommodative spasm. Magnetic resonance imaging showed no evidence of injury to her brain stem, frontal lobes or oculomotor nerve. The patient is now well adjusted with a −3.50DS corrective lens for the right eye.Conclusions and importanceThe accommodation reflex is susceptible to injury at the occipital lobe, frontal eye fields, Edinger-Westphal nuclei and oculomotor nerves. As such it should be examined in patients who present with visual disturbances following whiplash injury.It is important that such cases are identified at presentation, as early intervention can improve outcomes in accommodative spasm and reduce the long term psychological effects often associated with whiplash injuries.

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An atypical case of head trauma with late onset of contrecoup epidural hematoma, cerebellar contusion, and cerebral infarction in the territory of the recurrent artery of Heubner

Cited by 7 publications

References 29 publications

Contrecoup Acute Epidural Hematoma—A Rare Case Report

Contrecoup Acute Epidural Hematoma—A Rare Case Report

Intracranial Parasagittal Epidural Abscess: Another Consideration for the Etiology of Acute Headache and Fever Following a Minor Head Injury

Persistent pseudomyopia following a whiplash injury in a previously emmetropic woman

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