Cases reported "Hematoma, Subdural"

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1/16. Abrupt exacerbation of acute subdural hematoma mimicking benign acute epidural hematoma on computed tomography--case report.

    A 75-year-old male was hit by a car, when riding a bicycle. The diagnosis of acute epidural hematoma was made based on computed tomography (CT) findings of lentiform hematoma in the left temporal region. On admission he had only moderate occipitalgia and amnesia of the accident, so conservative therapy was administered. Thirty-three hours later, he suddenly developed severe headache, vomiting, and anisocoria just after a positional change. CT revealed typical acute subdural hematoma (ASDH), which was confirmed by emergent decompressive craniectomy. He was vegetative postoperatively and died of pneumonia one month later. Emergent surgical exploration is recommended for this type of ASDH even if the symptoms are mild due to aged atrophic brain.
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ranking = 1
keywords = decompressive craniectomy, craniectomy, decompressive
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2/16. Bilateral subdural hematomas following routine lumbar diskectomy.

    intracranial hypotension is a rare, and possibly underrecognized, cause of headache in middle age. Occurring spontaneously in the vast majority of cases, it has been occasionally reported after certain neurosurgical procedures involving craniectomy. We report a unique situation in which a patient developed severe postural headache typical of intracranial hypotension, which was complicated by bilateral subdural hematomas, immediately following a routine lumbar diskectomy; the headache resolved spontaneously. We suggest that an intraoperative microscopic dural breach was the site of sustained, but self-limited, cerebrospinal fluid leakage that eventually led to intracranial hypotension.
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ranking = 0.15677997999814
keywords = craniectomy
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3/16. Is Chiari I malformation in the aged initiated by mechanical factors? Report of three cases.

    Three cases in which the signs and symptoms of Chiari I malformation were induced and worsened after the occurrence of supratentorial mass lesions are reported. The symptoms improved markedly after removal of the supratentorial lesions in these cases. In the first case, a meningioma in the right parietal region coexisted with Chiari I malformation. Although the cerebellar ataxia and nystagmus disappeared after tumor removal, decompressive surgery for the malformation was performed because of upper cervical nerve symptoms and the patient recovered completely. In the second case, the symptoms first occurred after a car accident, and a computed tomographic scan revealed not only a subdural hematoma, but also tonsillar herniation due to Chiari I malformation. After evacuation of the hematoma and decompressive surgery on the craniospinal junction, the symptoms disappeared. In the third case, the symptoms of malformation developed gradually with depression and gait disturbance. A meningioma in the left frontal region coexisted with Chiari I malformation. Although the symptoms improved remarkably after tumor removal, decompressive surgery on the craniospinal junction was performed because of upper cervical nerve symptoms, and the patient recovered completely. These clinical findings indicate that a supratentorial mass lesion may provoke the symptoms of Chiari I malformation in the aged.
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ranking = 0.18341897770577
keywords = decompressive
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4/16. Subdural hematomas in boxing: the spectrum of consequences.

    boxing is a violent sport in which every participant accepts the risk of brain damage or death. This sport has been linked to acute neurological injury and chronic brain damage. The most common life-threatening injury encountered by its participants is subdural hematoma (SDH), and the most feared consequence of chronic insult to the nervous system is dementia pugilistica, or punch drunkenness. Although advances in imaging and neuropsychological testing have improved our ability to diagnose these injuries, the unprecedented sensitivity and wide availability of these modalities have increased the detection of mild cognitive impairment and small, asymptomatic imaging abnormalities. The question has thus been raised as to where on the spectrum of these injuries an athlete should be permanently banned from the sport. In this report the authors describe six boxers who were evaluated for SDH sustained during participation in the sport, and who experienced remarkably different outcomes. Their presentations, clinical courses, and boxing careers are detailed. The athletes ranged in age from 24 to 55 years at the time of injury. Two were female and four were male; half of them were amateurs and half were professionals. Treatments ranged from observation only to decompressive craniectomy. Two of the athletes were allowed to participate in the sport after their injury (one following a lengthy legal battle), with no known sequelae. One boxer died within 48 hours of her injury and at least two suffered permanent neurological deficits. In a third, dementia pugilistica was diagnosed 40 years later, and the man died while institutionalized.
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ranking = 1
keywords = decompressive craniectomy, craniectomy, decompressive
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5/16. Delayed onset of intraventricular hemorrhage following removal of acute subdural hematoma--case report.

    A 68-year-old male presented with neurological deterioration after a lucid interval following head trauma. Computed tomographic (CT) scans on admission demonstrated a subdural hematoma in the right frontotemporal region accompanied by subarachnoid hemorrhage in the right Sylvian and interhemispheric fissures. The subdural hematoma was removed via a right frontotemporoparietal craniectomy. However, immediate postoperative CT scans revealed hemorrhage in the third and both lateral ventricles, apparently separate from the primary hemorrhages. Decompressive rupture of damaged subependymal veins is suggested as the cause of the delayed traumatic intraventricular hemorrhage.
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ranking = 0.15677997999814
keywords = craniectomy
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6/16. Acute epidural hematoma following decompressive surgery of a subdural hematoma.

    We report a patient with acute epidural hematoma diagnosed using computed tomography shortly after decompressive surgery of a contralateral subdural hematoma not resulting in clinical evidence of improvement. The patient underwent successful second emergency decompressive surgery. Prompt recognition is essential for a successful outcome, and poor recovery, when not otherwise anticipated, should alert immediately to a possible contralateral hematoma.
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ranking = 0.36683795541153
keywords = decompressive
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7/16. Intracerebral hematoma after evacuation of chronic subdural hematoma.

    A case of intracerebral hemorrhage occurring after evacuation of a chronic subdural hematoma is presented. The mechanism of this complication is not clear. However, hemorrhage into previously undetected areas of contusion, damage to cerebral vasculature secondary to rapid perioperative parenchymal shift, and sudden increase in cerebral blood flow with focal disruption of autoregulation have been postulated as causes. Although this is a rare complication after decompressive operation for chronic subdural hematoma, it should be suspected and investigated without delay in patients who deteriorate postoperatively.
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ranking = 0.061139659235255
keywords = decompressive
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8/16. Acute spinal subdural hematoma. A case report and review of literature.

    A case of acute spinal subdural hematoma is reported in a 24-year-old woman. Presentation occurred in the postpartum period, 4 days following epidural anesthesia. Emergency decompressive laminectomy attained partial recovery. Subsequent pathology demonstrated evidence of a low-grade ependymoma. Reported cases of spinal subdural hematomas are reviewed and compared with the characteristics of this unique case.
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ranking = 0.061139659235255
keywords = decompressive
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9/16. Endoscopic removal of organized chronic subdural hematoma.

    An endoscopic surgical approach to organized chronic subdural hematoma is described. Advantages of the endoscopic approach include access to virtually the entire hematoma cavity through a small craniectomy performed with local-standby anesthesia. Two illustrative cases are presented.
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ranking = 0.15677997999814
keywords = craniectomy
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10/16. Rapid infusion system for neurosurgical treatment of massive intraoperative hemorrhage.

    Using an illustrative case of severe closed head injury that resulted in a posterior fossa epidural hematoma (EDH) and supratentorial epidural/subdural hematomas (SDH), the massive blood losses associated with operative repair of the torn sigmoid sinus and the significant fluid losses associated with refractory diabetes insipidus were treated by the intraoperative use of the Rapid Infusion System (RIS, Haemonetics). The RIS can rapidly infuse warm blood, crystalloid, or colloid at rates up to 1.5 L/min, thereby limiting the commonly associated hypotension, hypothermia, and coagulopathies. During the suboccipital craniectomy for evacuation of the EDH and repair of the sigmoid sinus, the patient required 18 units of blood replacement secondary to a large tear in the sigmoid sinus. During a separate craniotomy for evacuation of the SDH, the patient also developed diabetes insipidus, which increased the operative fluid replacement to 39 L. Despite these massive blood and fluid losses, the RIS limited the hypotension to less than 2 min and prevented hypothermia and the frequently associated coagulopathies. When used in a neurosurgical setting associated with massive blood and/or fluid losses, the RIS accomplishes three important objectives: (1) rapid infusion of intravenous fluids for maintaining perfusion pressure, (2) rapid warming of fluids despite high intravenous infusion rates of cold crystalloids, thereby preventing intraoperative hypothermia, and (3) continuous monitoring of infusion rates and totals.
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ranking = 0.15677997999814
keywords = craniectomy
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