SUBDURAL HqMATOMA A REVIEW OF 389 CASES

A 76-year-old man presented with brain stem hemorrhage after burr-hole drainage for bilateral chronic subdural hematomas. Neuroimaging demonstrated resolution of the transtentorial herniation but also detected new brain stem hemorrhage, manifesting as gait disturbance. He recovered after conservative treatment. Asymmetrical and rapid decompression, which leads to vascular disruption and/or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem hemorrhage. Therefore, simultaneous and bilateral decompression with a slow rate of evacuation of massive bilateral chronic subdural hematomas is recommended to prevent serious complications such as secondary intracranial hematoma.

show abstract

“…10,17) The present patient survived the brain stem hemorrhage that developed after the evacuation of bilateral CSDHs.…”

Section: Discussionmentioning

confidence: 70%

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

Park

Kang

Lee

et al. 2009

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…Esta constatação pode ser ilustrada analisando-se o resultado de diferentes séries com mortalidade amplamente variável 5,15,16,22,24,28,29.…”

Section: Chronic Subdural Hematoma: Surgical Treatment and Results Inunclassified

Hematoma subdural crônico tratamento cirúrgico e resultados em 96 pacientes operados

Salomão

Leibinger

Lynch

1990

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

TRATAMENTO CIRÚRGICO E RESULTADOS EM 96 PACIENTES OPERADOS J. FRANCISCO SALOMÃO -RENÊ D. LEIBINGER -JOSÉ CARLOS LYNCHRESUMO -Os autores apresentam os resultados cirúrgicos de 96 casos de hematoma subdural crônico operados por meio de orifícios de trépano ou pequenas trefinas: 78 pacientes (81,3%) foram considerados curados, 6 (6,2%) apresentaram seqüelas e 12 (12,5%) faleceram. Os óbitos de natureza neurocirúrgica foram relacionados à intensidade do comprometimento neurológico por ocasião da cirurgia. A idade avançada associada à presença de doenças sistêmicas também teve influência na mortalidade. Seqüelas neurológicas foram observadas principalmente em pacientes submetidos a reoperações por reacúmulo do hematoma e em portadores de lesões bilaterais. Os autores chamam a atenção para a ocorrência de hipotensão intracraniana associada a colapso cerebral. A importância do diagnóstico precoce e cirurgia imediata são enfatizadas. Chronic subdural hematoma: surgical treatment and results in 96 operated patients.SUMMARY -Ninety-six patients with chronic subdural hematoma were treated surgically and their clinical features presented in detail. Carotid angiography gave the correct diagnosis in all patients. CT scan was performed in 38 and was diagnostic in 92.1% of the cases. The clots were removed through burr-holes or small trephines: 78 (81.3%) patients were cured, 6 (6.2%) had permanent disabilities and 12 (12.5%) died. Operative mortality was related to the degree of neurological impairment, advanced age and systemic diseases. Neurologic sequelae were mostly related to reoperations due to recurrence of the hematoma and bilateral clots, as well. Low intracranial pressure syndrome with brain colapse was seen in 3 cases and treated with lumbar injection of saline solution. The delay in diagnosis and operation as cause of bad outcome is stressed.Embora os hematomas subdurals crônicos sejam universalmente considerados uma das patologias intracranianas de evolução mais favorável, os resultados de seu tratamento cirúrgico nem sempre refletem esta benignidade 13. Esta constatação pode ser ilustrada analisando-se o resultado de diferentes séries com mortalidade amplamente variável 5,15,16,22,24,28,29.Estes dados se explicam basicamente em função do quadro clínico muitas vezes inespecífico, à ausência de relato ou banalidade dos antecedentes traumáticos e à falta de atenção para o diagnóstico da doença, freqüente-mente rotulada como acidente cerebrovascular ou demência aterosclerótica 21 .A escassez de relatos sobre o assunto na literatura nacional justifica o presente estudo.

show abstract

“…Up to 1.75% cases of acute SDH occur in the posterior fossa, 12,13) usually secondary to trauma or anticoagulation therapy. Some cases may develop into chronic SDHs, an occurrence which seems commoner at the extremes of age.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Retrocerebellar Arachnoid Cysts Exerting Mass Effect and Associated With Cerebellar Tonsillar Ectopia in an Otherwise Healthy Adult

Killeen

Tromop-Van-Dalen

Alexander

et al. 2013

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Rarely, midline or unilateral posterior fossa arachnoid cysts (ACs) exert local mass effect resulting in the symptoms and signs of cerebellar and brainstem dysfunction. These cysts are sometimes seen in conjunction with cerebellar tonsillar ectopia (TE), although the relationship between these two entities is unclear. Bilateral ACs in the posterior fossa are virtually unprecedented. We describe the case of a 33-year-old man with a history of multiple minor head injuries observed to harbour asymptomatic, bilateral cerebrospinal fluid-density collections over the cerebellar hemispheres. Six years later, he presented with headaches, limb paraesthesias, and drop attacks. Computed tomography, magnetic resonance imaging, and operative findings during burrhole drainage of the lesions showed bilateral posterior fossa ACs, with associated cerebellar TE of 11 mm. The cysts partially recurred, necessitating reopening of the burrholes, after which the patient's symptoms resolved entirely. We then discuss the challenges in diagnosing this unusual case, the relationship between AC and TE, and the role of minor head injury in the symptomatic progression of AC.

show abstract

SUBDURAL HqMATOMA A REVIEW OF 389 CASES

Cited by 287 publications

References 2 publications

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

Hematoma subdural crônico tratamento cirúrgico e resultados em 96 pacientes operados

Bilateral Retrocerebellar Arachnoid Cysts Exerting Mass Effect and Associated With Cerebellar Tonsillar Ectopia in an Otherwise Healthy Adult

Contact Info

Product

Resources

About