Surgical Management of Severe Closed Head Injury in Adults

Pascual, José M.; Prieto, R.

doi:10.1016/b978-1-4160-6839-6.10133-9

Cited by 9 publications

(17 citation statements)

References 128 publications

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“…We hypothesize that, in our case, the hematoma developed between The source of bleed in acute extradural hematomas can either be arterial [3] (from a meningeal artery), venous (from diploic veins), or from a skull fracture [4] . Those that arise from the veins and skull fractures are low-pressure bleeds [4] . It is difficult to hypothesize as to the source of the bleed that resulted in the formation of the hematoma in our case.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Intralaminar Hematoma Developing between Cranial Dural Layers: A Case Report

Bahuleyan

Patel²,

Usurumarthi³

et al. 2017

Pediatr Neurosurg

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We present a case of post-traumatic hematoma developing between the 2 layers of the cranial dura in a 2-year-old child following head injury. This child presented with history of fall from a height in altered sensorium with paucity of movements on the left side. Computerized tomography scan of the brain showed a right parietal linear fracture with an underlying hyperdense biconvex hematoma. Emergency evacuation of the hematoma was done. On elevation of the scalp flap, a fibrous membrane was seen protruding between the fracture lines. Following craniotomy, the hematoma was identified between the 2 layers of the dura and the fibrous membrane that protruded between the fracture lines was identified as the endosteal layer of dura. The hematoma was evacuated after opening the outer endosteal layer. After evacuation of the hematoma, the endosteal and meningeal layers could be identified separately and the point where these 2 layers split to enclose the hematoma was identified at the outer border of the hematoma. The child had no neurological sequel at the time of discharge.

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Section: Discussionmentioning

confidence: 99%

Posttraumatic Intralaminar Hematoma Developing between Cranial Dural Layers: A Case Report

Bahuleyan

Patel²,

Usurumarthi³

et al. 2017

Pediatr Neurosurg

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“…Hair is clipped and the surgical site is prepped and draped in the usual sterile fashion. 8,10,11 A large question-mark-shaped incision is frequently used. This provides access to the floor of the middle fossa for temporal lobe decompression as well as visualization of the draining veins along the vertex, which may be the source of the hemorrhage in subdural hematomas.…”

Section: Trauma Craniotomymentioning

confidence: 99%

“…Without a wide durotomy and division of the falx, the brain is unable to sufficiently expand outwards, leading to cortical contusion and shearing injury of the frontal and temporal lobes as they are compressed by dura. 8,10 A large onlay collagen-matrix substitute is placed over the cortical surface to cover the dural defect. In a unilateral decompressive craniectomy, the surgical technique is similar to a standard trauma craniotomy as described above.…”

Section: Decompressive Craniectomymentioning

confidence: 99%

“…This is especially true in elderly patients where cerebral atrophy increases stretch of these draining veins. 8 Other causes of subdural hematomas include bleeding from contused cortex or a lacerated cortical vessel. 8 The inciting incident resulting in a subdural hematoma differs greatly based on age.…”

Section: Subdural Hematomamentioning

confidence: 99%

“…Patients with conservative management should still be monitored closely and a repeat CT scan should be obtained immediately if the patient has any decline in mental status or develops any focal neurologic deficits. 5,8 stomach and is at elevated risk for aspiration. For this reason, rapid sequence induction is typically favored.…”

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confidence: 99%

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Neurosurgical Management in Traumatic Brain Injury

2015

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Severe traumatic brain injury (TBI) is one of the most complex and diverse pathologic medical conditions. Each year, approximately 100,000 patients require neurosurgical evacuation of an intracranial hematoma in the United States. It is essential, early in the clinical course, to distinguish those patients with severe TBI who require operative intervention from those who can be managed with only conservative measures. The surgical technique employed is determined primarily by the specific underlying pathology in conjunction with the patient's other comorbidities.

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