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At least 19 recordsLinked to original sources
PubMed1984

[A case of infected subdural hematoma (subdural empyema) secondary to septicemia caused by agranulocytosis].

A 76-year-old female was admitted with a headache. She had no febrile course before admission. Computed tomography (CT) demonstrated bilateral frontal hypodense areas without enhanced rim. She was made a diagnosis of a chronic subdural hematoma. Because her general condition was poor and she had no neurological deficit, she was planned to be treated conservatively. On a few days after the admission, she was suffered from agranulocytosis. However, leukopenia disappeared within a few days by the effective treatment and any neurological deficit was not observed in these period. On thirty days after the admission, she rapidly became semicomatous state and showed left side hemiparesis. A subdural empyema was demonstrated by the subsequent operation. Both culture of subdural fluid and urine yielded Escherichia coli. Her neurological deficits cleared after the operation and subsequent antibiotic therapy. We speculated that infection of urinary tract produced a E. coli bacteremia and subsequently infected subdural hematoma occurred by this microorganism. We stressed that when the neurological deterioration was observed during the conservative treatment of chronic subdural hematoma, infected hematoma would be one which should be one differentiated from an enlargement of hematoma. The mechanisms of the rim enhancement observed at CT are also discussed.

Aged↗
PubMed1987

[Subdural tension pneumocephalus following surgery of chronic subdural hematoma].

Subdural tension pneumocephalus (TP) following surgery for chronic subdural hematoma was analyzed in 5 cases from clinical standpoints of view, especially from CT findings. The cases were compared with 14 cases of subdural asymptomatic pneumocephalus (AP). The TP tends to complicate elderly patients who showed a poor re-expansion of the brain after irrigation of bilateral chronic subdural hematoma. In such patients, it is difficult to make an exact diagnosis of TP because of residual mass effect of the evacuated hematoma. Significance of mass effect caused by subdural air has been discussed in the literature only little. In this study, we found two new CT findings suggesting increased tension of subdural air. First, the subdural tensive air separates and compresses the frontal lobes. The compressed frontal lobes with widened interhemispheric space between the frontal poles mimic the silhouette of Mt. Fuji. We called this CT finding "Mt. Fuji" sign. The presence of air between the frontal poles associated with massive air over the frontal lobes presumably indicates an increased tension of the subdural air. "Mt. Fuji" sign was seen in 4 cases out of 5 TP cases. Another sign is the presence of multiple small air bubbles in the subarachnoid space, especially in the cisterns. We proposed that these air bubbles were trapped in the subarachnoid space through a tear of the arachnoid membrane which is caused by increased tension of air in the subdural space. This finding was present in 4 cases with TP. We emphasize that these two CT signs are helpful to make an accurate diagnosis of TP following surgery for chronic subdural hematoma.

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PubMed1977

Peritoneal dialysis: a temporizing means for hemodialysis patients with subdural hematomas.

Subdural hematoma has a higher mortality rate with hemodialysis patients than the normal population. One reason for this is the coagulation abnormalities of hemodialyzed patients. One case of a successfully treated subdural hematoma in a chronic peritoneal dialysis patient is presented. Changing the mode of dialysis from hemodialysis to peritoneal dialysis in a patient suspected of having a subdural hematoma may be beneficial in improving overally survival.

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PubMed1979

Chorea: a late complication of a subdural hematoma.

Subdural hematoma has rarely been implicated as a cause of chorea. We describe a case of chorea occurring several months after evacuation of a traumatic subdural hematoma. No other causes of chorea were found. In this case and one previously reported case, signs of tentorial herniation were present prior to surgery. Herniation may damage the basal ganglia, with resultant chorea.

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PubMed1992

Transient ischemic attack (TIA) secondary to subdural hematoma.

Subdural hematomas many sometimes clinically resemble Transient Ischemic Attacks (TIA's). We present three cases which were initially evaluated for, diagnosed as having and were treated for TIA's, but later were found to have subdural hematomas. As in case one, patients with subdurals may have antecedent head trauma which they may or may not recall. Patients presenting with symptoms resembling TIA's need a complete neurologic evaluation. The differential diagnosis for TIA's includes arteriosclerotic extracranial vascular disease, cardiac emboli, migraine, seizure disorder, and mass lesions. Since the prognosis and treatment differs one needs to determine the etiology of the symptoms before treatment is initiated. Specifically, other diagnoses must be excluded prior to anticoagulation therapy, as evidenced by case 2.

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PubMed1997

[A case of infected subdural hematoma complicating chronic subdural hematoma in a healthy adult man].

The authors report a case of so-called "infected subdural hematoma" as a complication of chronic subdural hematoma. The patient was a 55-year-old man who had sustained a small laceration of the forehead in a traffic accident on March 29, 1995. No fractures were detected on skull roentgenograms, and general and neurological examinations failed to reveal any abnormal findings. In early August 1995, the patient began to experience headaches, and on August 5 he developed a fever of 38 degrees C. On August 8 he suffered a left motor seizure and was admitted to our hospital. Laboratory studies revealed a peripheral leukocyte count of 10,800/mm3 and a C-reactive protein level of 18.1 mg/dl. Computed tomography scans showed a thick right fronto-parietal subdural low density mass and a thin left frontal subdural low density mass. An emergency operation was performed via a single right fronto-parietal burr hole. A chronic subdural hematoma containing slightly yellowish, bloody, purulent fluid was found beneath an outer membrane. The hematoma was irrigated with physiological saline containing antibiotics, and a drain was inserted into the subdural space. A subdural membrane was also present on the left but it contained no pus. Aggressive antibiotic therapy was performed, and the patient was discharged without any neurological deficit. Histologically the membrane was determined to be the outer membrane of a typical chronic subdural hematoma. Enterococcus faecalis, which has rarely been reported to cause infection of the central nervous system, was detected in a bacterial culture of the pus. Systemic investigation showed no evidence of otorhinologic or other focal infection. The above clinical findings suggested that hematogenous seeding of a chronic subdural hematoma had occurred in this patient. Subdural empyema arising from hematogenous seeding to a pre-existing subdural hematoma by an infection is very rare, but this type of complication must be kept in mind not only in the elderly, infants, and compromised hosts, but in patients without complications as well.

Chronic Disease↗
PubMed1983

Subdural hematomas. I. Acute subdural hematoma: progress in definition, clinical pathology, and therapy.

A series of 206 patients with clotted subdural hematomas operated within 3 days of closed head injury is presented. Sixty-two percent (128) were operated within 24 hours of trauma (acute subdural hematoma) carrying a high incidence of sterotypic motor posturing, impaired oculomotor reflexes, and unilateral dilated fixed pupil. A functional recovery occurred in 27% and a vegetative state or death resulted in 62%. The remaining 38% were operated after 24 but within 72 hours from injury (early subacute subdural hematoma) and generally had less severe neurologic dysfunction. A functional recovery occurred in 54% and vegetative state or death in 34%. The 128 acute cases are presented in detail to establish a logical basis for time differential. The cases requiring operation within 12 hours of injury were the most challenging. Improved outcome is felt to result from prompt referral and large craniotomy in the earliest hours after injury, combined with careful postoperative monitoring. Clinical, operative and autopsy findings are presented and discussed in relation to pathogenesis.

Acute Disease↗
PubMed2006

Subacute spinal subdural hematoma associated with intracranial subdural hematoma.

We describe a subacute spinal subdural hematoma in a patient with psot-traumatic subacute intracranial subdural hematoma. CT and MRI demonstrated hematoma within the interhemispheric subdural space and at the lumbar posterior subdural space which extended from the L1 to the S2 level. The lesion showed high signal intensity on both T1 and T2 weighted images. Surgical decompression of the spinal subdural hematoma was performed. The symptoms completely resolved after surgery. Spinal subdural hematoma may be concomitant with or may occur after intracranial subdural hematoma. If a patient with intracranial subdural hematoma complains of low back pain and weakness in both legs; lumbosacral MR examination should be performed to exclude spinal subdural hematoma.

Craniocerebral Trauma↗
PubMed2002

[A case of infected subdural hematoma following chronic subdural hematoma irrigation].

A 71-year-old female complicating Parkinson disease and diabetes mellitus was admitted to our medical center for urinary tract infection one month after burr hole irrigation and drainage of left chronic subdural hematoma. Klebsiella pneumonia was detected in the bacterial culture of her urine. As antibiotic therapy started, her condition and peripheral white blood cell counts were improved. But consciousness level got worsened and right hemiparesis appeared. A CT scan showed re-accumulation of left subdural fluid so an emergent irrigation was performed. The old hematoma with slightly yellowish, bloody purulent fluid was found and an intracapsular drain was inserted. Klebsiella pneumonia was detected from the bacterial culture of the hematoma. After 10 days, a CT scan showed subdural fluid collection again, so, total hematoma capsule removal was performed. After the operation, her neurological and serological condition improved and she was discharged without any neurological deficits. Klebsiella pneumonia existing urinary tracts rarely infected subdural hematoma cavity via hematogenous dissemination. We must keep in mind this complication may occur when we see compromised host like this case. Total removal of infected hematoma capsule is considered as radical treatment.

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PubMed2004

Traumatic acute subdural hygroma mimicking acute subdural hematoma.

Subdural hygroma is a frequent delayed complication of head trauma. Most hygromas are clinically 'silent' and a few cases have shown slow deterioration in the chronic stage. We report a case of subdural hygroma showing unique radiological findings and rapid deterioration. A 74-years-old female presented with a mild headache and consciousness disturbance after head injury. Computed tomography showed a midline shift as a result of two components piling up in the subdural space; the outer components showed low density, the inner components high density. Magnetic resonance imaging demonstrated that these two subdural components were subdural hygroma and subarachnoid hematoma. Simple burr hole irrigation, rather than large craniotomy, was thought to be more appropriate treatment to reduce the mass effect. Simple burr hole irrigation was performed to remove the subdural hygroma and the patient showed an excellent recovery. Careful examination of the radiological findings prevented an unnecessary procedure in this case. A possible mechanism of this phenomenon is discussed.

Acute Disease↗
PubMed2001

A modified technique to treat subdural hematomas: the subdural evacuating port system.

BACKGROUND: The Subdural Evacuating Port System (SEPS) is intended for drainage of subdural fluid collections such as hygromas and hematomas. Unlike other subdural fluid drainage systems, no drain is placed in the subdural space. This paper describes the technique and reports our experience thus far. METHODS: We treated 20 patients for 22 subdural hematomas. One or two ports were inserted for drainage of each subdural collection. Follow-up ranged from six to 24 months. RESULTS: Follow-up CT obtained at approximately one month postprocedure showed complete or near complete resolution of 18 of the subdural collections. Failure of the SEPS was noted in four patients and was related to plugging of the drainage system by clots secondary to the presence of fresh blood in the subdural collection. CONCLUSIONS: The Subdural Evacuating Port System (SEPS) permits the neurosurgeon to drain subacute or chronic hematomas by a method which is minimally invasive, simple and safe.

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PubMed2006

Contralateral development of chronic subdural hematoma after evacuation of chronic subdural hematoma. A case report.

Contralateral acute complications such as acute epi/subdural hematomas can be encountered after evacuation of a chronic subdural hematoma, though they are rare. We found only one case of chronic subdural hematoma following the surgery for contralateral chronic subdural hematoma, have been published in English language literature. A 73-year-old male admitted to our hospital with a right-sided subdural hematoma. The subdural hematoma was evacuated through a burr-hole. A left-sided subdural higroma appeared after operation and turned into classical subdural hematoma in the course of time. After evacuation of contralateral chronic subdural hematoma, the patient recovered completely. All stages of the development of contralateral chronic subdural hematomas were shown by serial computed tomograms. It was suggested that traumatic chronic subdural hematomas develop from mostly subdural higromas. If contralateral subdural higroma is seen after surgical evacuation of a chronic subdural hematoma, the possibility of development of contralateral chronic subdural hematoma must be kept on mind.

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PubMed1992

Contralateral development of acute subdural hematoma following surgery for chronic subdural hematoma--case report.

An unusual case of acute subdural hematoma developed after drainage of chronic subdural hematoma in a 71-year-old male. The acute subdural hematoma was located over a membranous layer in the subdural space similar to the outer membrane of the chronic subdural hematoma. Intraoperatively, bleeding from the bridging vein and oozing from the superior sagittal sinus were observed. The membranous layer probably separated from the dura mater following decompression after drainage of the contralateral hematoma, and this separation then damaged the bridging vein and superior sagittal sinus, resulting in the acute subdural hematoma.

Acute Disease↗