1/11. Spontaneous intracranial hypotension associated with bilateral chronic subdural hematomas--case report.A 34-year-old female presented with spontaneous intracranial hypotension (SIH) manifesting as severe postural headache and meningism. Magnetic resonance (MR) imaging with gadolinium showed diffuse pachymeningeal enhancement. She developed bilateral chronic subdural hematomas 4 weeks after the onset of the symptoms. MR imaging showed descent of the midline structures of the brain. The bilateral chronic subdural hematomas were surgically drained, with no remarkable pressure. Postoperative MR imaging showed complete resolution of the pachymeningeal enhancement and relevation of the midline structures of the brain. SIH is an uncommon and probably unrecognized condition because of the usually benign course. However, this case emphasizes that SIH is not entirely benign. SIH should be considered if there is no identifiable risk for intracranial hemorrhage, particularly in young patients. Neurosurgical intervention for the treatment of the underlying cerebrospinal fluid leak may be required if SIH persists.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/11. Organized chronic subdural hematoma requiring craniotomy--five case reports.Two child and three elderly patients underwent craniotomy for organized and/or partially calcified chronic subdural hematomas (CSHs). The characteristic feature of magnetic resonance imaging was a heterogeneous web-like structure in the hematoma cavity. Both children had undergone one side subduroperitoneal shunt for bilateral CSHs when infants. As a result, the opposite hematoma cavities persisted and developed into calcified CSHs after a couple of years. All three elderly patients with senile brain atrophy showed various systemic complications such as cerebral infarction, diabetes mellitus, leg ulceration, cirrhosis, and bleeding tendency. craniotomy for removal of the hematoma and calcification achieved good results in all patients. subdural space created by shunt, craniotomy, or brain atrophy and persisting for a certain period, and additional various brain damage such as microcirculatory disorder, meningitis, encephalitis, or premature delivery may be important in generating calcified or organized CSH.- - - - - - - - - - ranking = 1.5keywords = brain (Clic here for more details about this article) |
3/11. Ruptured middle cerebral artery aneurysm and bilateral chronic subdural hematomas.BACKGROUND: While rupture of a cerebral aneurysm into the subdural space is rare, aneurysmal subarachnoid hemorrhage in the presence of subdural hematoma(s) is much more uncommon. Such a patient requires changes in routine perioperative management.CASE DESCRIPTION: A patient with a ruptured middle cerebral artery bifurcation aneurysm and bilateral subdural hematomas is presented. He underwent successful aneurysm clipping and subdural hematoma evacuations. At the time of surgery, measures commonly used to obtain brain relaxation were avoided. The patient was kept normovolemic, normocarbic, and normotensive. He recovered completely and resumed his prior occupation.CONCLUSIONS: Changes in standard techniques for a patient undergoing a pterional craniotomy for a ruptured cerebral aneurysm are required when bilateral extra-axial mass lesions are present.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
4/11. Chronic subdural hemorrhage into a giant arachnoidal cyst (Galassi classification type III).The authors present CT and MRI of a patient with an extremely large arachnoidal cyst (Galassi classification type III). The cyst extended from the base of the skull, posterior to the brain stem, on the base of the temporal lobe over the complete convexity of the left hemisphere. The cyst consisted of multiple compartments with intracystic septa and was accompanied by a chronic subdural hemorrhage in the compartments. After contrast agent application, the typical characteristics of chronic subdural membranes were found. Besides bony deformities, a thinning of the inner table was found. The patient underwent craniotomy for evacuation of the hemorrhage and fenestration of the septa while he was free of symptoms. This is a remarkable case proving that chronic local intracranial pressure does not inevitably lead to neurologic symptoms or intellectual disabilities.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
5/11. A modified technique to treat chronic and subacute subdural hematoma: technical note.BACKGROUND: We present a patient on warfarin in whom a drainage port system was attached to the skull, successfully draining a subacute subdural hematoma. CASE DESCRIPTION: An elderly male presented to our institution with right hemiparesis a week following a motor vehicle accident. He was on warfarin for recurrent pulmonary emboli and suffered from severe coronary artery disease. physical examination demonstrated a grade 3/5 hemiparesis and a computerized tomography (CT) scan confirmed the diagnosis of subacute subdural hematoma. He underwent twist drill craniostomy and attachment of the subdural evacuating port system. Recovery in this patient was dramatic. CONCLUSION: The subdural evacuating port system (SEPS) permits the neurosurgeon to drain subacute or chronic hematomas by a method that is minimally invasive, simple, and safe. The SEPS appears to promote brain expansion without the potential biohazards of other standard techniques.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
6/11. 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 = 201.41041988717keywords = haemorrhage, brain (Clic here for more details about this article) |
7/11. korsakoff syndrome following chronic subdural hematoma.We describe a patient who developed korsakoff syndrome following a spontaneous chronic subdural hematoma. The present case demonstrates persistence of both amnesia and confabulation long after recovery from the acute phase of spontaneous chronic subdural hematoma. There are few reports describing persistent amnesia with confabulation following brain damage. We considered that chronic subdural hematoma in the bilateral frontal and temporal lobes caused amnesia and confabulations, and these conditions persisted as a result of organic atrophic changes of both the frontal and temporal lobes due to long-term compression by chronic subdural hematoma.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
8/11. Subfalcine herniation in the absence of a high pressure collection or mass: 'brain-slump'?Subfalcine brain herniation is well documented in the presence of raised intracranial pressure. However, we report a case of herniation occurring after decompression of bilateral chronic subdural haematomas, which did not appear to be related to high pressure. We suggest that after rapid decompression of a collection, the unsupported brain can herniate under the falx with serious consequences: 'brain-slump'.- - - - - - - - - - ranking = 3.5keywords = brain (Clic here for more details about this article) |
9/11. Acute on chronic subdural hematoma in a female boxer: a case report.INTRODUCTION: Although the sport of female boxing has a long history, the activity's current popularity is unprecedented. As more women participate, we can expect them to experience many of the serious neurologic injuries observed in their male counterparts. We present the first reported subdural hematoma in a female secondary to boxing and critique management decisions made by the athlete's trainer/coach. CASE REPORT: A 24-yr-old right-handed female boxer developed headaches of increasing intensity, nausea, and emesis after being knocked down while sparring. She was allowed to continue training despite persistent symptoms and participated in a match 2 wk after the incident that was stopped due to intolerable headache. Computed tomography scan of the brain revealed a large heterogeneous subdural fluid collection over the left cerebral hemisphere, causing effacement of the adjacent sulci and a large left-to-right midline shift, consistent with an acute on chronic subdural hematoma. After surgical evacuation, the patient reported persistent memory, concentration, and language problems. Neuropsychological evaluation was performed and revealed deficits in confrontational naming, information retrieval, and concentration difficulty. DISCUSSION: Several factors may increase the female participants' risk for acute neurological injury. The activity's current popularity and high demand with fans results in rapid advancement of inexperienced fighters, which leads to dangerous mismatches. Intergender sparring is common, and return to competition guidelines utilized for male participants are often not adhered to. This report is timely in that female athletes are more often crossing into previously male dominated sports and should serve as a reminder that these participants are vulnerable to similar injuries. Previous safety guidelines should be utilized in this new population of participants.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
10/11. Chronic subdural haematoma and arachnoid cyst in autosomal dominant polycystic kidney disease (ADPKD).We present the unusual association between chronic subdural haematoma (CSDH), intracranial arachnoid cyst and autosomal dominant polycystic kidney disease (ADPKD) in a 27-year-old man. CSDH is a documented complication of intracranial arachnoid cyst, the incidence of which is increased in patients with ADPKD. awareness of this association may lead to earlier diagnosis of ADPKD and treatment of its systemic complications, including renal insufficiency, systemic hypertension and previously unsuspected intracranial saccular aneurysm. Surgery for CSDH associated with intracranial arachnoid cyst may be complicated by over-drainage of cerebrospinal fluid due to communication between the cyst and the cisternal subarachnoid space, as illustrated in the present case, and the development of epidural haemorrhage.- - - - - - - - - - ranking = 33.485069981195keywords = haemorrhage (Clic here for more details about this article) |
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