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At least 775 records · Page 43Linked to original sources
PubMed2004

Traumatic subdural hydroma developing into chronic subdural hematoma.

OBJECTIVE: To probe the incidence, pathogenesis and clinical characteristics of traumatic subdural hydroma (TSH) developing into chronic subdural hematoma (CSDH). METHODS: We retrospectively analyzed the clinical data of 32 patients with TSH developing into CSDH and reviewed related literature. RESULTS: 16.7% of TSH developed into CSDH in this study. The time of evolution was from 22 to 100 days after head injury. All the patients were cured with hematoma drainage. CONCLUSIONS: TSH is one of the origins of CSDH. The clinical characteristics of TSH developing into CSDH follow that the ages of the patients are polarized, that the evolution often happens in the patients with small chronic hydromas and being treated conservatively, that the patients are usually injured deceleratedly and that the accompanying cerebral damage is often very mild.

Adolescent↗
PubMed2003

Intracranial hypotension syndrome: a comprehensive review.

Intracranial hypotension may have variable clinical presentations, but has a rather uniform component of postural headache among its symptomatology. Its symptoms are explainable given the effects of the hypotension and attempts within the craniospinal axis to maintain volume homeostasis in the face of cerebrospinal fluid leakage (Monro-Kellie hypothesis). The imaging corollaries of the consequences of intracranial hypotension are especially well depicted on magnetic resonance imaging studies.

Adult↗
PubMed2004

[Intracranial hypovolemic syndrome with subdural hygroma developed massive hematoma: timing of treatment and histology of dural hypertrophy].

We report a case of a 43-year-old man treated by craniotomy for chronical subdural hematoma (CSH) due to spontaneous intracranial hypovolemia. The patient complained of sudden onset severe headache. Initial CT scan showed normal brain structure, and his headache improved with bed rest in a few days. However, MR images obtained for vertigo one month later demonstrated bilateral subdural hygroma extending to the supracerebellar space and diffuse dural enhancement after gadolinium infusion. We diagnosed bilateral subdural hygroma due to spontaneous intracranial hypovolemia, and observed him conservatively. Four months after onset, he complained of severe headache again and MR images revealed enlargement of bilateral CSH with mass effect, which had heterogenous intensity on the right convexity. We evacuated hematoma on the right by craniotomy and aspirated the left side hematoma using a burr hole. His headache improved 2 weeks after the operation with strict bed rest. The follow-up MR images showed disappearance of abnormal meningeal enhancement and improvement of brain sagging.

Adult↗
PubMed2005

The use of hydroxyapatite cement and a pericranial/deep temporal fascia graft for cranioplastic reconstruction of translabyrinthine craniectomy defects.

Most translabyrinthine temporal bone defects are reconstructed with free abdominal fat grafts, with or without the use of hydroxyapatite cement. However, these procedures are associated with considerable morbidity at the graft donor site, with a 6 to 15% incidence of cerebrospinal fluid (CSF) leaks, and with postoperative headaches. We have developed a new technique for reconstructive cranioplasty that involves the use of hydroxyapatite cement and a pericranial/deep temporal fascia graft. This technique obviates the need for an abdominal fat graft and therefore circumvents the morbidity associated with it; it may also significantly reduce the incidence of CSF leaks and postoperative headaches. We describe the results of our use of this technique in a series of 10 patients. Based on our early findings, we believe that this technique holds great promise for reconstructive cranioplasty following translabyrinthine craniectomy.

Adult↗
PubMedDate not supplied

[Vein of Galen arteriovenous malformations and neonatal convulsions].

INTRODUCTION: Vein of Galen arteriovenous malformation (VGAM) appears during the embryonic period and gives rise to a complex network of arterial and venous vessels that generates a blood shift, from the brain parenchyma towards the malformation, with haemodynamic repercussions. Heart failure is the most frequent presenting symptom during the neonatal period, yet, convulsions or other neurological signs have occasionally been reported in this stage of life. CASE REPORT: A term infant with symptoms of heart failure and convulsions that began during the first 12 hours of life. CAT and magnetic resonance angiography scans revealed a vascular malformation and areas of cerebral ischaemia. CONCLUSIONS: In the case of our patient, detecting areas of ischaemia in the cerebral hemispheres suggested that the damage could be caused by a "steal" syndrome leading the blood flow away from these areas towards the malformation. This situation can occur either before or after birth and the self-limiting nature of the seizures in cerebral infarcts could lead to them going noticed because they take place inside the uterus or when the patient is not being observed directly by his or her health care providers. We suspect that the convulsions in newborn infants with this malformation may well be more frequent than is currently believed.

Bradycardia↗
PubMed2004

[Subdural hygroma after cerebellopontine angle tumor surgery: a case report].

The primary treatment modality for cerebellopontine angle (CPA) tumors is surgery. In the postoperative period, collection of subdural hygroma (SDH) is a rarely encountered complication. This paper presents a 58-year-old male patient who underwent surgery for right acoustic neuroma and developed a SDH postoperatively. Subdural hygroma, even though rarely seen, is a serious complication following CPA tumor surgery, calling for early diagnosis and treatment. Definition, diagnosis, clinical aspects, and treatment of SDH are discussed.

Cerebellar Neoplasms↗
PubMed2005

[Radionuclide cisternography for patients suspected of having intracranial hypotension].

We evaluated radionuclide cisternography for the diagnosis of intracranial hypotension in terms of the rate of appearance of abnormal findings in 23 patients, their correlation with therapy, and the most suitable scanning method and timing for visualization of leakage. During the first hour after injection, dynamic lumbar images or consecutively repeated whole-body images were acquired. Whole body images then were acquired at 1, 5, and 24 hours. Until 5 hours after injection, patients were kept in bed resting. Visualization of the leakage (direct finding) and that of the bladder (indirect finding) were observed in 78.3% (18/23) and 60.9% (14/23), respectively. Leakage was visualized most frequently at 5 hours after injection. There were three cases in which the leakage was only visualized at 24 hours. Therefore, there must be cases that show intermittent CSF leakage. To avoid overlooking these cases, a 24-hour whole-body image is also important. The appropriate procedure of radionuclide cisternography is very important to detect CSF leakage, and our procedure proved to be more effective for detecting the abnormal findings.

Accidents, Traffic↗
PubMed2006

Technical review and considerations for a cerebrospinal fluid leakage study.

Within the past decade, published diagnostic algorithms for cerebrospinal fluid (CSF) leakage have included beta-2-transferrin analysis, rigid nasal endoscopy, high-resolution CT, CT cisternography, CT fluorescein lumbar puncture, and MRI but have not included the nuclear medicine CSF leakage study. However, some physicians still use this study today. This case report reviews the procedure and data calculations for the study. The presented case demonstrates how patient ingenuity in maintaining a compromised pledget for counting after sneezing contributed to the final diagnostic outcome. The patient was a 58-y-old man who presented with persistent nasal drainage and headaches, with no history of previous head trauma or surgery. The patient was referred to the nuclear medicine department for a CSF leakage study, which had positive findings and led to a final diagnosis of a large dural and skull defect posteriorly over the ethmoid sinuses.

Cerebrospinal Fluid↗
PubMed2006

[Case of intracranial hypotension responsive to oral prednisolone].

A 31-year-old female patient with headache and nausea was admitted to our hospital, although there were no apparent neurological abnormalities except headache. Cerebrospinal fluid (CSF) pressure was 40 mmH2O on the first lumbar puncture and CT showed some fluid in the left maxillary sinus. She gradually developed orthostatic headache despite antibiotics, hydration and analgesics. MRI showed diffuse meningeal thickening and enhancement. CSF pressure was 0 mmH2O on the second lumbar puncture and RI cisternography demonstrated early excretion to the kidneys. She was diagnosed with intracranial hypotension due to CSF leakage. An autologous 10ml blood patch on the lumbar epidural space did not relieve the orthostatic headache. However, headache disappeared one day after oral intake of 40mg prednisolone. During the next three months, oral prednisolone was tapered off. Three months after the onset of the illness, MRI did not show either meningeal thickening or enhancement. We concluded that oral prednisolone was effective in a case of intracranial hypotension.

Administration, Oral↗
PubMedDate not supplied

Posttraumatic diffuse cerebral lesions. Relationship between clinical course, CT findings and ICP.

One hundred and fifty patients with posttraumatic diffuse cerebral lesions were reviewed. Criteria of inclusion were immediate coma and CT appearance of diffuse lesions, that were classified as follows: (a) Diffuse axonal injury (70 cases): patients with normal CT scan (50 cases) and patients with shearing injury (focal hemorrhages in corpus callosum, basal ganglia and brain stem; gliding contusions) (20 cases); (b) Diffuse brain swelling (80 cases): reduced or absent lateral ventricles, absence of 3rd ventricle and basal cisterns. Many of these patients had either subarachnoid haemorrhage or subdural blood effusion. Clinical course and mortality rate were in a ranking order in the considered groups. Patients with normal CT had a less severe coma and a better outcome than patients with shearing injury and diffuse brain swelling. There was evidence of high intracranial pressure in 75% of the patients with brain swelling, whereas no patient with normal CT had ICP elevation. Diffuse axonal injury represents a primary posttraumatic diffuse lesion. Secondary vascular involvement, due to hypoxia, shock and other unknown causes, is responsible for the appearance of vasoparesis, hyperemia and diffuse brain swelling.

Adult↗
PubMedDate not supplied

Non-traumatic subdural hygroma.

Subdural hygroma consists of a cerebrospinal fluid-like subdural fluid collection with a low oncotic pressure in comparison with venous blood. Its etiology and pathophysiology, which may be different from other subdural fluid collections, are reviewed. We report the clinical history of a 80-year-old woman with a bilateral frontal subdural hygroma. Serial CT-scanning demonstrated a rapid increase in volume after two years of slow evolution. In our patient dehydration may have been the triggering factor. The course of non-traumatic subdural hygroma is not well known. This report illustrates that subdural hygroma can have a dramatic evolution and that therapeutic decisions in these patients should be based on repeated CT-scans.

Aged↗
PubMed1989

Morbidity and mortality of bacterial meningitis in Arab children.

Between September 1981 and March 1987, 92 episodes of bacterial meningitis in 90 children were treated in three major hospitals in Kuwait. The diagnosis was bacteriologically confirmed in 80 (87%). Haemophilus influenzae was the most common aetiological organism and accounted for 42 episodes (45.6%) followed by Streptococcus pneumoniae in 21 (22.8%) and Neisseria meningitidis in only three (3.3%). Bacterial meningitis occurred in 53 children (57.6%) below the age of 1 year and in 81 (88%) below 5 years. The overall case fatality rate was 5.4% and ten children (9%) had severe neurological sequelae of their disease. Sequelae were more common following pneumococcal meningitis (28%) than after Haemophilus (7%). All 12 children with unknown pathogen recovered completely.

Age Factors↗
PubMed1989

[Pericerebral collections. Analysis of neuroradiologic and radionuclide tests and therapeutic results].

The authors retrospectively studied 32 neonates with macrocrania associated with a pericerebral collection. Differential diagnosis was made between external communicating hydrocephalus, atypical communicating hydrocephalus, subdural hygroma and local cerebral atrophy by means of CT scan, isotope cisternography, and isotope brain scintigraphy. Especially the two last examinations are of great interest. The most important arguments in favour of operation were a rapidly increasing and uncontrolled head circumference graph and a deterioration of the psychomotor development. In this regard, 13 out of 25 patients with external communicating hydrocephalus were operated upon (lumbo-peritoneal shunt). The analysis of the results reveals that rapidly increasing macrocrania is a good operative indication and gives excellent results but psychomotor deterioration turned into normal evolution only in 14% of the operated cases. Evacuation of a subdural hydroma first by external and followed later on by internal drainage normalizes the clinical picture.

Atrophy↗
PubMed1989

[Treatment of chronic subdural collection in infants by subdural peritoneostomy].

Between 1980 and 1987, 50 chronics bilateral subdural collections in infants were treated by means of a subdural peritoneal shunt (unilateral in 48 cases, bilateral in 2 cases). In 2 patients with huge macrocranium the drains were left in situ. In the 48 others, the drains were removed after an average of 10 months. In these 48 cases, the drainages either bilateral (2 cases) or unilateral (46 cases) led to the disappearance of the collections; however, in 1 of these 48, a drain had to be reinserted due to the reproduction of the collection following the removal of the initial drainage. High level of C.S.F. protein content did not alter the peritoneal resorption. Obstruction of the catheter by a clot occurred in 3 cases with grossly bloody collections. Unilateral subdural peritoneal drainage for bilateral pericerebral collection is an efficient and safe treatment. The authors should advocate temporary external drainage only in the cases where the collection is grossly bloody.

Chronic Disease↗
PubMedDate not supplied

[Historical and current concept of benign intracranial hypertension].

The concepts of serous meningitis, pseudotumour cerebri, hypertensive meningeal state and otitic hydrocephalus have not been considered historically as synonyms nor can they be superimposed on what is currently known as Benign Intracranial Hypertension (BIH). BIH is a syndrome of intracranial hypertension with no clinical, radiological or analytical evidence for the existence of focal or general neurological lesions or hydrocephalus, and which has a self-limiting "benign" development. At present, the diagnostic criteria usually accepted are: 1. Symptoms and signs of intracranial hypertension. 2. Absence of focal neurological symptoms and signs. 3. Absence of radiologically verified cerebral lesion. 4. C.S.F. of normal composition and high pressure. The requirement of other criteria for the diagnosis of BIH, such as angiography, to eliminate the possibility of thrombosis of venous sinuses, or continuous monitoring of C.S.F. pressure, is controversial.

History, 19th Century↗