1/11. Aspirating subdural effusions, so called brain stem shock.A shift of blood into the head during negative pressure aspiration of subdural haematomas in an infant has been demonstrated, and also that aspiration may restart bleeding. An estimate of the elasticity of a 47 cm circumference skull has been obtained. It is suggested that the observed changes in distribution of blood are sufficient to explain the occasional deaths of infants after aspiration of subdural haematomas and that so-called "brain stem shock" need not be invoked.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
2/11. Posterior fossa subdural hygroma with supratentorial chronic subdural haematoma.Posterior fossa subdural hygromas are very rare. They tend to occur following direct occipital trauma. We present an unusual case of complex subdural hygroma of the posterior fossa, which was associated with a supratentorial chronic subdural haematoma. This developed after an apparently minor injury to the head. The unusual features of our case are discussed. We also review the literature and discuss the natural history and pathogenesis of subdural hygroma.- - - - - - - - - - ranking = 2.5keywords = haematoma (Clic here for more details about this article) |
3/11. Spontaneous arachnoid cyst rupture in a previously asymptomatic child: a case report.arachnoid cysts are benign congenital cavities arising in the subarachnoid space. Non-traumatic subdural effusion of cerebrospinal fluid is a rare complication requiring surgical treatment. CASE REPORT: A 15-year-old boy was admitted to the hospital because of symptoms related to acute intracranial hypertension (headache and vomiting). The cerebral CT-scan revealed a subdural hygroma adjoining a voluminous Sylvian arachnoid cyst. Two arachnoid cysts were incidentally discovered 11 years before this dramatic complication. Moreover, the patient had suffered a cerebral concussion 2 years earlier, but interestingly did not develop cystic hemorrhage or rupture, contrary to numerous cases previously described in the literature. The location of the cysts and their regular follow-up did not allow foreseeing a cystic rupture. Hygroma evacuation was first performed after which a subdural peritoneal shunting, using a programmable opening pressure valve, was implanted. Spontaneous rupture into the subdural space represents an unusual complication of arachnoid cysts. Clinical aspects, radiographic findings, pathogenesis and surgical management are described. It is important to point out that subdural hygroma or haematoma should never be excluded in the absence of trauma history, even in the case of small non-progressive cysts regularly supervised.- - - - - - - - - - ranking = 0.5keywords = haematoma (Clic here for more details about this article) |
4/11. Chronic subdural haematoma after riding a roller coaster.We report a 20-year-old man who developed a chronic subdural haematoma (CSDH) after riding a "giant" roller coaster. The patient had a past history of a subdural hygroma, diagnosed six weeks after a motorcycle accident. Three months after this accident, he rode on a roller coaster, but suffered no direct head trauma during the ride. Three weeks later, he developed a CSDH requiring surgical evacuation. Roller coaster riding, associated with high velocities and extreme acceleration/deceleration forces is a modern cause of CSDH in the young, which may be increasing due to ever-faster rides.- - - - - - - - - - ranking = 2.5keywords = haematoma (Clic here for more details about this article) |
5/11. Bilateral subdural haematomata and lumbar pseudomeningocele due to a chronic leakage of liquor cerebrospinalis after a lumbar discectomy with the application of ADCON-L gel.The anti-adhesion gel ADCON-L has been available since the end of the 1990s. During disc surgery it can be applied to the spinal nerve roots and the dura mater spinalis in order to inhibit fibroblast migration and thus avoid postoperative adhesions or excessive keloids, respectively. Due to the way ADCON-L works, inadvertent, intraoperational dural lesions may stay open much longer than usual because ADCON-L inhibits the natural healing process. Possible consequences are a chronic leakage of cerebrospinal fluid in combination with intracranial hypotension syndrome. We report on a patient who underwent lumbar disc surgery with application of ADCON-L gel. Postoperatively he suffered from acute headache, nausea, and vomiting. A lumbar pseudomeningocele was demonstrated on magnetic resonance imaging (MRI). Furthermore, cranial MRI revealed bilateral, chronic subdural haematomata which indicated intracranial hypotension syndrome or continuous leakage of cerebrospinal fluid at the lumbar site. With conservative treatment the problems were gradually reduced and eventually the subdural haematomata were no longer detected. The pseudomeningocele persisted over a 4 month period of observation. Because of the complications we found, the local application of ADCON-L during lumbar disc surgery should be critically evaluated.- - - - - - - - - - ranking = 3keywords = haematoma (Clic here for more details about this article) |
6/11. Rapid fluctuations in conscious state in a patient with an extensive spinal dural fistula.A man with a spontaneous spinal dural fistula and significant fluctuations in level of consciousness is discussed. The presentation was that of headache and vomiting followed by an initially enigmatic acute reduction in the level of consciousness. This required urgent evacuation of bilateral chronic subdural haematomas, believed to be causative. Following mobilisation, several episodes of presumed orthostatic intracranial hypotension occurred rendering the patient rapidly unconscious. A large spinal extradural CSF collection extending through the full length of the vertebral canal was later diagnosed however, the precise location of the fistulous leak could not be found radiologically. Non-operative management was successful. To the best of our knowledge, this is the first description of a spontaneous spinal cerebrospinal fluid leak of this magnitude. The case, pathogenesis, investigations and management of this rare entity are considered and the literature reviewed.- - - - - - - - - - ranking = 0.5keywords = haematoma (Clic here for more details about this article) |
7/11. facial nerve palsy-an unusual complication after evacuation of a subdural haematoma or hygroma in children.OBJECTIVE: This paper reports and discusses on the possible etiology of postoperative contralateral facial nerve palsy after uneventful evacuation of a subdural haematoma or hygroma after mild head trauma in two children with pre-existing middle cranial fossa subarachnoid cysts. RESULTS: Two 14- and 15-year-old boys had prolonged headaches after mild head injuries. CT showed a right-sided middle cranial fossa arachnoid cyst in each patient. In one patient, an ipsilateral subdural haematoma was identified, and in the other, bilateral hygromas were identified. Exacerbation of symptoms required emergency evacuation of the subdural haematoma in the first child, and bilateral external drainage of the hygroma in the other child. In both children the late postoperative period was complicated by peripheral facial nerve palsies contralateral to the arachnoid cyst. CONCLUSION: facial nerve palsy may be a complication of hygroma or haematoma drainage. The etiology is not clear; traction of the facial nerve due to displacement of the brainstem may be the most likely explanation.- - - - - - - - - - ranking = 4keywords = haematoma (Clic here for more details about this article) |
8/11. Subdural fluid collections following transcortical approach to intra- or paraventricular tumours.Subdural fluid collections appeared in 15 cases (39%) after removal of 38 intra- and paraventricular tumours in the third or lateral ventricle through 18 frontal and 20 parietal transcortical approaches. Transient fluid collections which disappeared within 2 weeks occurred in 6 cases (16%) and persistent ones in 9 cases (24%). Four of the 9 cases (11%) of collections required surgical treatment because of positive clinical signs and symptoms. Two cases had expansive fluid collections and the other two contained subdural haematomas at surgery. The risk factors likely to contribute to a persistent collection were preoperative ventriculomegaly (frontal horn index greater than 0.38) and a frontal transcortical approach. A symptomatic collection should be considered as a potential complication of the transcortical approach to intraventricular tumours and some methods should be devised to prevent it when intra- or paraventricular tumours with ventriculomegaly are removed.- - - - - - - - - - ranking = 0.5keywords = haematoma (Clic here for more details about this article) |
9/11. Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma.Thirteen of 145 patients with post-traumatic subdural hygroma (SDHy) developed chronic subdural haematoma (CSDH) at the involved site over a period of 6 years. CSDHs were found at the site of SDHys with no history of further head injury at a mean interval of 56 days. It appeared that these 13 patients did not have any distinguishing clinical features early on. Old age and brain atrophy on CT scans do not seem to be reasonable causative factors in the evolution of SDHy into CSDH. Initial enlargement of subdural accumulations at an early stage of SDHy and a subsequent increase in density at a later stage may point to the development of CSDH from SDHy in some instances. Ten of these 13 CSDH cases underwent surgical drainage, and the remaining 3 cases received no specific management. All resolved completely. The prognosis was good in all patients. The possible mechanism for the evolution of SDHy into CSDH is discussed.- - - - - - - - - - ranking = 2.5keywords = haematoma (Clic here for more details about this article) |
10/11. Cranial MRI and MR angiography in Menkes' syndrome.We report two boys with Menkes' syndrome who underwent cranial MRI and MR angiography (MRA). In both, CT and MRI revealed progressive cerebral atrophy with a subdural haematoma or effusion. Delayed myelination or dysmyelination of the white matter was suggested. Tortuosity of the cervical and intracranial vessels was well demonstrated by MRA, obviating more invasive conventional angiography should it be thought necessary to demonstrate the characteristic systemic vascular changes of this syndrome.- - - - - - - - - - ranking = 0.5keywords = haematoma (Clic here for more details about this article) |
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