Protein analysis of subdural hygroma fluid

Wetterling, Tilman; Demierre, B.; Rama, B.; Nekic, M.

doi:10.1007/bf01400533

Cited by 32 publications

(21 citation statements)

References 23 publications

(1 reference statement)

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“…Subdural hygroma fluid noted in severe head injury and DC is usually xanthochromic, contains a varied number of red blood cells, and is high in protein. 15,39,40,61,62,65,71,73 Hygroma fluid aspirated in 5 patients at the Shock Trauma Center contained high numbers of red blood cells and high protein levels ( Table 2). Evidence indicates that this high-protein, highly xanthochromic fluid induces an inflammatory response in the subdural space, predisposing to neomembrane formation with fragile and leaky capillaries.…”

Section: Iatrogenic Surgical Disruption Of the Arachnoiddura Interfacementioning

confidence: 99%

Dynamics of subdural hygroma following decompressive craniectomy: a comparative study

Aarabi¹,

Chesler²,

Maulucci³

et al. 2009

FOC

100

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Object This retrospective comparative cohort study was aimed at discovering the risk factors associated with subdural hygroma (SDG) following decompressive craniectomy (DC) to relieve intracranial hypertension in severe head injury. Methods Sixty-eight of 104 patients who had undergone DC during a 48-month period and survived > 30 days were eligible for this study. To assess the dynamics of subdural fluid collections, the authors compared CT scanning data from and the characteristics of 39 patients who had SDGs with the data in 29 patients who did not have hygromas. Variables significant in the appearance, evolution, and resolution of this complication were analyzed in a 36-week longitudinal study. Results The earliest imaging evidence of SDG was seen during the 1st week after DC. The SDG volume peaked between Weeks 3 and 4 post-DC and was gradually resolved by the 17th week. Among the mechanisms of injury, motor vehicle accidents were most often linked to the development of an SDG after DC (p < 0.0007), and falls were least often associated (p < 0.005). Moreover, patients with diffuse brain injury were more prone to this complication (p < 0.0299) than those with an evacuated mass (p < 0.0001). There were no statistically significant differences between patients with and without hygromas in terms of age, sex, Glasgow Coma Scale score, intraventricular and subarachnoid hemorrhage, levels of intracranial pressure and cerebral perfusion pressure, timing of decompression, and the need for CSF diversion. More than 90% of the SDGs were ipsilateral to the side of the craniectomy, and 3 (8%) of 39 SDGs showed evidence of internal bleeding at ~ 8 weeks postinjury. Surgical evacuation was needed in 4 patients with SDGs. Conclusions High dynamic accidents and patients with diffuse injury were more prone to SDGs. Close to 8% of SDGs converted themselves into subdural hematomas at ~ 2 months postinjury. Although SDGs developed in 39 (~ 60%) of 68 post-DC patients, surgical evacuation was needed in only 4.

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Section: Iatrogenic Surgical Disruption Of the Arachnoiddura Interfacementioning

confidence: 99%

Dynamics of subdural hygroma following decompressive craniectomy: a comparative study

Aarabi¹,

Chesler²,

Maulucci³

et al. 2009

FOC

100

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“…(Nattziger, 1924;Da Costa and Adson, 1941;Miura et al 1975;French et al 1978;Fujioka et al 1981;Stone et al1981;Yoshimasu et al 1981;Wetterling et al 1988). In this study, the initial accumulation of TSH was found to develop between 1 h and 72 hs in 13 (68%) of 19 patients after the initial head injury.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, the authors have diagnosed 19 patients with traumatic subdural hygroma (TSH), which was identified by serial CT. Various theories have been proposed about the mechanism contributing to the development of TSH after head injury (Nattziger, 1924;Wetterling et al 1988), but its pathogenesis still remains unclear. ( Table 2).…”

Section: Introductionmentioning

confidence: 99%

Clinical Analysis of Nineteen Patients with Traumatic Subdural Hygromas.

1994

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“…Radiotracer and cisternography studies performed in infants with SDHy were able to show that radioisotopes (eg, indium-111) injected into the subarachnoid space move into the subdural compartment. 44,53 In addition, the CSF-specific ␤-trace protein and other proteins have been found up to 100% of SDHys, 74,75 indicating that there really is CSF in the subdural space.…”

Section: Concept 2: Rapid Formation Of Subdural Hygromasmentioning

confidence: 99%

“…33,47,58,59 Thus, the fate of SDHy is either resolution or cSDH formation. 33,59,75 Under a normal pressure situation, the SDHy resolves. If the decreased intracranial pressure that had led to SDHy formation continues, the SDHy may expand.…”

Section: Differential Diagnoses Of Subdural Hygromasmentioning

confidence: 99%

Subdural Hygromas in Abusive Head Trauma: Pathogenesis, Diagnosis, and Forensic Implications

Wittschieber¹,

Karger²,

Niederstadt

et al. 2014

AJNR Am J Neuroradiol

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SUMMARY:Are subdural hygromas the result of abusive head trauma? CT and MR imaging represent important tools for the diagnosis of abusive head trauma in living infants. In addition, in-depth understanding of the pathogenesis of subdural hygromas is increasingly required by neuroradiologists, pediatricians, and forensic physicians. Therefore, the current knowledge on subdural hygromas is summarized and forensic conclusions are drawn. The most important diagnostic pitfalls, benign enlargement of the subarachnoid space, and chronic subdural hematoma, are discussed in detail. Illustrative cases from forensic practice are presented. Literature analysis indicates that subdural hygromas can occur immediately or be delayed. If other infrequent reasons can be excluded, the presence of subdural hygromas strongly suggests a posttraumatic state and should prompt the physician to search for other signs of abuse. To differentiate subdural hygromas from other pathologies, additional MR imaging of the infant's head is indispensable after initial CT scan. ABBREVIATIONS:AHT ϭ abusive head trauma; BESS ϭ benign enlargement of subarachnoid space; BV ϭ bridging vein; cSDH ϭ chronic subdural hematoma;

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Protein analysis of subdural hygroma fluid

Cited by 32 publications

References 23 publications

Dynamics of subdural hygroma following decompressive craniectomy: a comparative study

Dynamics of subdural hygroma following decompressive craniectomy: a comparative study

Clinical Analysis of Nineteen Patients with Traumatic Subdural Hygromas.

Subdural Hygromas in Abusive Head Trauma: Pathogenesis, Diagnosis, and Forensic Implications

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