1/19. Spontaneous chronic and subacute subdural haematoma in young adults.Spontaneous subacute and chronic haematoma in young adults is rare. It has not been previously reported in this age group. We present three cases of chronic and subacute subdural haematoma in young adults, in one of whom the diagnosis was certainly delayed. All three patients underwent burrhole evacuation and made a full neurological recovery. A cause for the haematoma was never established. The literature on the subject, which is scanty, is reviewed and the condition is briefly discussed. The aetiology remains obscure.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
2/19. Unilateral spatial neglect associated with chronic subdural haematoma: a case report.A 69-year-old right-handed man who exhibited unilateral spatial neglect in association with a chronic subdural haematoma, presented with mild left arm and leg weakness first noted 4 weeks prior to admission. neurologic examination on admission revealed a mild left hemiparesis, including the face. Neuropsychologic examination revealed left unilateral spatial neglect, but no language disturbance. Minimal support was necessary to maintain activities of daily living. Computed tomography revealed a large right temporoparietal, extraaxial hypodense fluid collection containing scattered hypodense foci. The haematoma was evacuated via a right parietal burr hole. Following surgery, the patient dramatically improved neurologically and neuropsychologically, as well as in independent performance of daily activities. It is suggested that the improvement in ADL provides a behavioural correlate of improvement in the latter, represented a behavioural correlate of improved cerebral function, and that either direct compression by the chronic subdural haematoma or an interhemispheric pressure difference had caused unilateral spatial neglect. Such neglect is an unusual consequence of chronic subdural haematoma.- - - - - - - - - - ranking = 1.1428571428571keywords = haematoma (Clic here for more details about this article) |
3/19. Subdural haematoma after dural puncture headache treated by epidural blood patch.Subdural haematoma is a well-documented complication of accidental dural puncture, and is thought to be preventable by prompt treatment with an epidural blood patch. An accidental dural puncture occurred in a 39-yr-old primagravida during the siting of an epidural catheter for pain relief in labour. Twenty hours after the puncture, the mother developed a typical postdural puncture headache, which increased in severity over the subsequent 24 h. An epidural blood patch was performed at 48 h, and this initially relieved the headache. After discharge from hospital, and 14 days after the dural puncture, the headache recurred, together with expressive dysphasia, poor co-ordination and sensory loss in the right arm. A magnetic resonance imaging scan demonstrated a left sided subdural haematoma, which was drained successfully with complete recovery.- - - - - - - - - - ranking = 0.85714285714286keywords = haematoma (Clic here for more details about this article) |
4/19. Bilateral multifocal uveal juvenile xanthogranuloma in a young boy with systemic disease.BACKGROUND: Juvenile xanthogranuloma is a rare non-Langerhans cell histiocytosis that could occasionally produce diffuse systemic disease in young children, but associated posterior uveal lesions are very uncommon. methods: Case report of an 8-month-old boy with macrocephaly who presented with chronic subdural haematoma and intracranial hypertension. A combination of nodular skin lesions and bilateral yellowish choroidal infiltration with limited retinal involvement suggested juvenile xanthogranuloma. RESULTS: The diagnosis was confirmed by a skin biopsy, and oral corticosteroid therapy was introduced. Progression of the disease to involve an anterior uveitis with hypopyon and numerous other systemic lesions, including the central nervous system, lung, liver, spleen, kidney and testis, was also suggestive of Letterer-Siwe disease. histiocytes were negative for Langerhans cell markers (S-100 and CD1a) and positive for macrophage marker (CD68). Electron microscopy failed to show Birbeck granules. Ocular lesions regressed under prolonged corticosteroid treatment, but resurgence of the other lesions required chemotherapy with vinblastine. CONCLUSION: In this atypical systemic variant of juvenile xanthogranuloma with bilateral uveal involvement, the immunohistochemical and ultrastructural findings were crucial in distinguishing juvenile xanthogranuloma from Langerhans cell histiocytosis.- - - - - - - - - - ranking = 0.14285714285714keywords = haematoma (Clic here for more details about this article) |
5/19. Spontaneous bilateral chronic subdural haematoma of the posterior fossa. Case report and review of the literature.INTRODUCTION: Chronic subdural haematomas of the posterior fossa in adults without a history of trauma are very rare. To our knowledge, only 15 cases have so far been reported in the literature, including those with anticoagulation therapy. A case of spontaneous bilateral infratentorial chronic subdural haematoma associated with anticoagulation therapy in an alive adult is presented and the relevant literature is reviewed. CASE REPORT: A 70 year old female presented with progressive dizziness, vertigo and gait ataxia. She was on anticoagulation therapy for heart disease. Neuro-imaging revealed bilateral infratentorial subdural masses. The subdural masses were suspects for chronic subdural haematomas by neuroradiological criteria. Because of the progressive symptomatology, the haematomas were emptied through burrhole trepanations. Chocolate-colored fluid, not containing clotted components, gushed out under great pressure. The source of bleeding could not be identified. The patient recovered well from surgery, but died 4 months later shortly after admission to another hospital from heart failure. DISCUSSION: The chronic subdural haematomas in this patient may have been due to rupture of bridging veins caused by a very mild trauma not noticed by the patient and possibly aggravated by the anticoagulation therapy. Infratentorial chronic subdural haematoma should at least be a part of the differential diagnosis in elderly patients with cerebellar and vestibular symptomatology even without a history of trauma.- - - - - - - - - - ranking = 1.4285714285714keywords = haematoma (Clic here for more details about this article) |
6/19. Chronic subdural haematoma after snowboard head injury.Two cases of chronic subdural haematoma following a snowboard head injury are reported. Although such cases are rare in sport, the risk in snowboarders is higher than expected. Evaluation of a snowboarder with a history of head injury, albeit mild, who complains of headaches should include computed tomography or magnetic resonance imaging to allow rapid identification of any intracranial pathology.- - - - - - - - - - ranking = 0.71428571428571keywords = haematoma (Clic here for more details about this article) |
7/19. 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 = 0.71428571428571keywords = haematoma (Clic here for more details about this article) |
8/19. Extensive craniofacial subcutaneous emphysema after evacuation of a chronic subdural haematoma.An unusual complication of craniofacial subcutaneous emphysema after evacuation of a chronic subdural haematoma is reported. The emphysema caused massive swelling and deformity of the patient's head and face, as well as the occlusion of both eyes, and it resolved spontaneously. The possible mechanisms of development of emphysema are discussed.- - - - - - - - - - ranking = 0.71428571428571keywords = haematoma (Clic here for more details about this article) |
9/19. Recurrent intracranial sarcoma mimicking chronic subdural haematoma.Primary sarcomas of the central nervous system and their coincidence with a subdural haematoma are each rare. We describe an unusual case of unsuspected dural spreading of a recurrent spindle cell sarcoma concealed in a chronic subdural haematoma, which occurred months after microsurgical resection and external radiation of a temporal parenchymatous sarcoma.- - - - - - - - - - ranking = 0.85714285714286keywords = haematoma (Clic here for more details about this article) |
10/19. Chronic subdural haematoma treatment with a rigid endoscope.Surgical treatment is the method of choice in cases of chronic subdural haematoma--as a rule: trephination, drainage with lavage, or repeated drainage (drain reinsertion where the haematoma has been evacuated insufficiently). A poorly manageable but non-negligible group is made up of patients (about 5-12 % of all cases) where the less invasive methods of choice keep failing. The equally mini-invasive endoscopic technique appears to be one of the suitable therapeutical approaches before resorting to open-surgery revision. The adapted technique of rigid endoscope insertion permitting sufficient revision and treatment of the subdural space concerned is presented. The method is demonstrated on three case reports where routine trephination with lavage, drainage and repeated drain insertion failed. A very good improvement in clinical condition and graphic findings was achieved in two patients. In the remaining one, the neurological lesion improved ad integrum despite a tiny residual haematoma as visualized by CT. Two weeks later, a clinical relapse had developed and the patient was treated with new trephination and drain reinsertion. The technical aspects of the modification of the endoscopic technique are discussed: stressing the advantages or low-degree invasiveness, scope for keeping intact the inner membrane of the haematoma and avoiding direct invasion of the cerebral tissue. The limits of the method are discussed as well. The authors regard this method as a useful addition to the surgical armamentarium, especially in cases of chronic subdural haematomas resisting conventional approaches.- - - - - - - - - - ranking = 1.2857142857143keywords = haematoma (Clic here for more details about this article) |
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