The role of endothelial gap junctions in the enlargement of chronic subdural hematomas

Yamashima, Tetsumori; Yamamoto, Shinjiro; Friede, Reinhard L.

doi:10.3171/jns.1983.59.2.0298

Cited by 149 publications

(83 citation statements)

References 9 publications

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“…1) Endothelial fenestrations and open gaps between adjacent endothelial cells of the macrocapillaries have also been observed. 20) The hematoma is typically dark red and liquefied, and fresh bleeding into the hematoma cavity can occur. 10) The hematoma includes high concentrations of fibrinolytic parameters such as tissue-type plasminogen activator, 7) plasmin-a 2 -plasmin inhibitor complex, 15) and fibrin and fibrinogen degradation products.…”

Section: Discussionmentioning

confidence: 99%

“…2,7,11,15,18) Increased vascular permeability and subsequent serum exudation from the outer membrane may also be involved in hematoma progression, supported by the observation that radioisotope-labeled albumin enters the hematoma cavity. 1,3,20) Subdural hygroma following minor head injury sometimes develops into CSH, 13,14) and this process can be visualized as a gradual increase in hematoma density on CT. However, bleeding into the hematoma cavity may not be the only factor in such changes.…”

Section: Discussionmentioning

confidence: 99%

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Various Magnetic Resonance Imaging Patterns of Chronic Subdural Hematomas: Indicators of the Pathogenesis?

Fujisawa

Nomura

Kajiwara

et al. 2006

Neurol. Med. Chir.(Tokyo)

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Magnetic resonance (MR) imaging can detect various patterns in chronic subdural hematomas. These patterns were compared to the computed tomography (CT) appearances and chemical analysis of the content in 60 hematomas from 44 patients. The hematomas could be classified into five types on both T 1 -and T 2 -weighted images: low, high, and mixed intensity, isointensity, and layered. Combining the T 1 -and T 2 -weighted images of all 60 hematomas revealed a total of 14 different imaging patterns. Combining the CT and MR imaging findings of 55 hematomas identified 25 different patterns. Analysis of the hematoma contents showed that hemolysis-related parameters, such as potassium, glutamate oxaloacetate transaminase, bilirubin, lactate dehydrogenase, and protein concentration, were markedly higher than in the peripheral blood, and there were significant correlations between these parameters. Mixed intensity hematomas were significantly thicker than the other types, and showed markedly higher values of hemolysis-related parameters. Factors affecting the CT and MR imaging findings, such as fresh bleeding, hemolysis, and hemoglobin changes, coexist in a hematoma to varying degrees, and these factors may interact with the age of the hematoma to produce the different patterns that are observed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Various Magnetic Resonance Imaging Patterns of Chronic Subdural Hematomas: Indicators of the Pathogenesis?

Fujisawa

Nomura

Kajiwara

et al. 2006

Neurol. Med. Chir.(Tokyo)

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“…Yamashima e col 19 , confirmam esta teoria para determinar o aumento do hematoma. A membrana externa do hematoma subdural crônico é rica em vasos, contendo capilares gigantes, com lúmen de 80 micra ou mais, mas que não apresentam musculatura lisa em sua parede 1419 .…”

Section: Discussionunclassified

Hematoma subdural crônico: análise de 35 casos

Araújo

Iafigliola

Balbo

1996

Arq. Neuro-Psiquiatr.

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RESUMO -Os autores relatam 35 casos com diagnóstico de hematoma subdural crônico, operados no período de janeiro-1988 a março-1995. A idade dos pacientes variou entre 19 e 80 anos. Foram eles agrupados retrospectivamente segundo a escala de Bender. Quanto ao tratamento cirúrgico, foram empregadas duas técnicas: craniotomia com membranectomia e dupla trepanação com instilação de solução salina na cavidade ocupada pelo hematoma. O índice de mortalidade entre os pacientes submetidos à craniotomia foi 16,6% e nos pacientes submetidos à trepanação foi nulo. Dentre os pacientes que faleceram, 80% encontravam-se em grau III ou IV na escala de Bender. O hematoma subdural crônico apresenta até os dias atuais alguns aspectos controversos, como quanto à sua fisiopatologia e ao tratamento cirúrgico adequado.PALAVRAS-CHAVES: hematoma subdural crônico, craniotomia, trepanação. Chronic subdural hematoma: analysis of 35 casesABSTRACT -Thirty five patients with chronic subdural hematoma were treated surgically between 1988 and 1995. The patients, aged 19 to 80 years, were graded retrospectively according to the Bender scale. The clots were removed via burr-holes with irrigation of the subdural space to ensure as complete an evacuation of subdural colletion, and craniotomy with membranectomy. The mortality rate was 16.6% with craniotomy and 0% with burr-hole. The patients who died, 80% were in grade III or IV. The pathogenesis and surgical treatment of chronic subdural hematoma has been controversial, and still remains obscure.KEY WORDS: chronic subdural hematoma, craniotomy, burr-hole evacuation.Os hematomas subdurals crônicos constituem condição neurocirúrgica potencialmente curável através de vários métodos cirúrgicos, mas ainda nos dias atuais com significativos índices de mortalidade, sendo a cura espontânea considerada ra ra 1,5,10,1214 .Uma série de 35 pacientes com diagnóstico de hematoma subdural crônico é apresentada e analisada frente a revisão bibliográfica do assunto. PACIENTES E MÉTODOSTrinta e cinco pacientes com o diagnóstico de hematoma subdural crônico foram tratados no período de janeiro-1988 a março-1995. Destes, 27 pacientes eram do sexo masculino e 8 do sexo feminino. A idade variou entre 19 a 80 anos, em 60% estando acima de 60 anos. O antecedente de traumatismo craniano estava presente em 68% dos casos.

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“…In reviewing an extensive body of literature including published articles and clinical cases, it is noted that many of the infants supposedly shaken exhibit not acute, but chronic subdural hematomas, which themselves are known to expand and present by rebleeding without accompanying trauma. [15][16][17]31) It is the ultimate genesis of such hematomas, generated weeks or even months before clinical presentation, that is addressed here.…”

Section: Introductionmentioning

confidence: 99%

The Shaken Baby Syndrome: An Odyssey -II Origins and Further Hypotheses-

Uscinski

McBride

2008

Neurol. Med. Chir.(Tokyo)

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Subdural bleeding in the so-called``shaken baby syndrome'' is recognized as a hallmark of this syndrome, and is often noted as chronic in nature, indicating an earlier time of origin than clinical presentation. In infants and neonates, the timeframe for generating such chronic intracranial bleeding is therefore limited. Neurosurgical, obstetric, and pediatric literature all recognize the significance of birth trauma in the generation of intracranial bleeding. This possibility is explored further here, with emphasis on features peculiar to Homo sapiens predisposing to intracranial bleeding during this timeframe. Encephalization and bipedalism combine to render the infant and mother susceptible to injury at birth.

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The role of endothelial gap junctions in the enlargement of chronic subdural hematomas

Cited by 149 publications

References 9 publications

Various Magnetic Resonance Imaging Patterns of Chronic Subdural Hematomas: Indicators of the Pathogenesis?

Various Magnetic Resonance Imaging Patterns of Chronic Subdural Hematomas: Indicators of the Pathogenesis?

Hematoma subdural crônico: análise de 35 casos

The Shaken Baby Syndrome: An Odyssey -II Origins and Further Hypotheses-

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