1/20. Hyperacute spinal subdural haematoma as a complication of lumbar spinal anaesthesia: MRI.We report two cases of hyperacute spinal subdural haematoma secondary to lumbar spinal anaesthesia, identified with MRI. Prompt diagnosis of this infrequent, potentially serious complication of spinal anaesthesia is essential, as early surgical evacuation may be needed. Suggestive MRI findings in this early phase include diffuse occupation filling of the spinal canal with poor delineation of the spinal cord on T1-weighted images, and a poorly-defined high-signal lesion with a low-signal rim on T2-weighted images.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
2/20. Cranial subdural haematoma associated with dural puncture in labour.A 23-yr-old primagravida sustained a dural puncture during epidural catheter insertion and developed a headache that settled with oral diclofenac and codydramol. On the third day after delivery, she convulsed twice without warning. As plasma urate was increased, the putative diagnosis of an eclamptic fit was made, and magnesium therapy was started. A contrast CT scan revealed that the cause of the patient's symptoms was a subdural haematoma with raised intracranial pressure. A coincidental arteriovenous malformation was noted. This case emphasises the need to consider the differential diagnoses of post-partum headache. The management of acute intracranial haematoma is described.- - - - - - - - - - ranking = 1.2keywords = haematoma (Clic here for more details about this article) |
3/20. cocaine-related acute subdural hematoma: an emergent cause of cerebrovascular accident.A case of "spontaneous" acute subdural hematoma caused by cocaine abuse is described. As an isolated cerebrovascular event, related to cocaine abuse, this is the first report in the literature. It also represents a new differential diagnosis for nontraumatic acute subdural haematomas. The putative pathophysiology of the lesion is discussed.- - - - - - - - - - ranking = 0.2keywords = haematoma (Clic here for more details about this article) |
4/20. Acute spontaneous spinal subdural haematoma: MRI features.We present MRI findings in three patients with acute spontaneous subdural haematomas of the spine. Acute haematomas (1-3 days) were isointense or gave slightly high signal on T1-and heterogeneous signal on T2-weighted images. MRI precisely defined the level and extent of the haematoma preoperatively. The MRI was prospectively correctly interpreted as acute subdural haematomas in all patients. As a specific, noninvasive modality, MRI is the preferred imaging technique in this rare clinical entity.- - - - - - - - - - ranking = 1.6keywords = haematoma (Clic here for more details about this article) |
5/20. Pure acute subdural haematoma without subarachnoid haemorrhage caused by rupture of internal carotid artery aneurysm.A 52-year-old female presented with disturbance of consciousness and clinical signs of tentorial herniation. Computed tomography showed a pure acute subdural haematoma (SDH) over the left convexity without subarachnoid haemorrhage. cerebral angiography showed a saccular aneurysm at the junction of the left internal carotid artery and the posterior communicating artery. Surgery to remove the haematoma and clip the aneurysm showed the rupture point was located in the anterior petroclinoid fold (subdural space). The patient recovered without neurological deficits. Pure SDH caused by ruptured aneurysm is rare. rupture of an aneurysm adhered to either the dura or falx and located in the subdural space may cause pure SDH. Therefore, ruptured intracranial aneurysm should be considered as a cause of non-traumatic SDH. Immediate removal of the SDH and aneurysmal clipping is recommended in such patients, even those in poor neurological condition.- - - - - - - - - - ranking = 1.2keywords = haematoma (Clic here for more details about this article) |
6/20. Remote hypertensive intracerebral haematoma following clipping of an intracranial aneurysm.We report a case of a 58-year-old woman who presented with an aneurysmal subarachnoid haemorrhage. Immediately following clipping of this aneurysm, she had a spontaneous hypertensive bleed in the contralateral hemisphere. Although very unusual, hypertensive episodes following aneurysmal subarachnoid haemorrhage must carry a risk of such an intracranial event.- - - - - - - - - - ranking = 0.8keywords = haematoma (Clic here for more details about this article) |
7/20. Pseudosubarachnoid haemorrhage in subdural haematoma.Two patients with large bilateral subdural haematomas with patterns of non-enhanced brain computed tomography (CT) falsely suggesting coexistent subarachnoid haemorrhage are presented. The CT images showed marked effacement of the basal cisterns with hyperdense signal along the tentorium, sylvian fissure, and the perimesencephalic cisterns. In both cases, the suspicion of subarachnoid haemorrhage led to the performance of angiographic studies to rule out vascular lesions. Thus, recognition of this radiological feature is important to avoid unnecessary testing and treatment delay.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
8/20. Bedside biochemical monitoring of the penumbra zone surrounding an evacuated acute subdural haematoma.We describe a penumbra zone with increased biochemical vulnerability in cerebral cortex underlying an evacuated acute subdural haematoma. Two microdialysis catheters were placed in this zone and one catheter was placed in the opposite, less injured hemisphere. The microdialysis perfusates were analysed bedside for glucose, pyruvate, lactate, glutamate, and glycerol. In the penumbra zone, but not in the opposite hemisphere, energy metabolism was seriously disturbed with signs of cell membrane degradation. During an adverse event (decrease in haemoglobin level, systemic blood pressure and cerebral perfusion pressure) the perturbation of energy metabolism increased in this zone. energy metabolism recovered and the signs of cell membrane degradation disappeared after normalization of the physiological parameters. We use the term biochemical penumbra zone to describe an area with signs of energy failure and cell membrane degradation, which has a capacity to regain a normal metabolic pattern but also an increased vulnerability to secondary insults.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
9/20. Subdural haematoma after trans-sphenoidal surgery.We report a patient with pituitary adenoma who developed a subdural haematoma following trans-sphenoidal surgery and conservative management of a postoperative CSF leak with a lumbar drain. The possible causes and methods of treatment are discussed and the neurosurgeon is alerted to the possibility of its development in similar situations.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
10/20. Haemangiopericytoma presenting as acute subdural haematoma.Haemangiopericytomas are vascular neoplasms that arise from capillary pericytes. They rarely present with haemorrhage. We report a patient whose meningeal tumour was revealed by acute subdural and intratumoural haemorrhage.- - - - - - - - - - ranking = 0.8keywords = haematoma (Clic here for more details about this article) |
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