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At least 19 recordsLinked to original sources
PubMed1983

[Sonographic detection of post-meningitis subdural effusion].

Subdural effusions in childhood are most often seen during the first year of life. In this age group two-dimensional echoencephalography gives excellent images of the brain due to the open fontanelle and the relatively low mineralisation of the cranium. The sonographic findings of two infants with postmeningeal subdural effusions are demonstrated and compared with CT-scan results. The sector-scan is much more useful than the linear-array. Computerized tomography remains necessary but it should be possible to reduce the number of examinations.

Echoencephalography↗
PubMed2000

Delayed magnetic resonance imaging with GdD-DTPA differentiates subdural hygroma and subdural effusion.

BACKGROUND: Posttraumatic subdural fluid collection is not a single clinical entity but can be divided into subdural hygroma and subdural effusion. Appropriate treatment requires preoperative differentiation. Delayed magnetic resonance (MR) imaging with intravenous administration of gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) was used to differentiate subdural hygroma and subdural effusion. METHODS: Timed arterial blood specimens were taken after intravenous Gd administration in patients with posttraumatic subdural fluid collections (five subdural hygromas and 13 subdural effusions). Delayed MR imaging was performed 1 hour after administration of Gd-DTPA. Gd-DTPA concentrations in the subdural fluid and blood specimens were measured by ion coupled plasma emission spectrometry. Dynamic biologic modeling was used to calculate the transfer rate constant for Gd-DTPA influx into these subdural fluid collections. RESULTS: The Gd concentrations in subdural hygromas and subdural effusions were 16 +/- 6 and 79 +/- 12 nmol/mL, respectively. The transfer rate constants for subdural hygromas and subdural effusions were 4.8 +/- 2.1 and 20.6 +/- 2.1 (x10(-4))min(-1), respectively. These values were significantly higher in subdural effusions than in subdural hygromas (p < 0.01). Delayed MR imaging with Gd showed significantly higher mean enhancement of 77.1 +/- 14.2% for subdural effusions compared to 4.6 +/- 3.1% for subdural hygromas (p < 0.01). CONCLUSIONS: Delayed MR imaging with Gd can differentiate subdural hygroma and subdural effusion.

Aged↗
PubMed1997

Infected subdural effusion associated with resolving subdural hematoma--case report.

A 70-year-old male presented with rapid neurological deterioration and fever 3 months after suffering a closed head trauma. He underwent craniotomy for possible subdural empyema based on computed tomography and clinical findings. Dural incision revealed an outer membrane typical of chronic subdural hematoma which covered a clear, yellowish fluid containing Campylobacter fetus. Histological examination confirmed the capsule of the hematoma, with a necrotic focus infiltrated by neutrophils. Administration of intravenous imipenem and topical tobramycin and cefalothin achieved total resolution of his neurological deficits. Development of the infected subdural effusion was probably secondary to bacterial infection in the pre-existing chronic subdural hematoma in the resolving stage. The presence of the hematoma capsule always carries the risk of development of an infectious focus.

Aged↗
PubMed1977

Subdural effusion: results after treatment with subdural-pleural shunts.

In an unselected material of 22 consecutive patients subdural effusion, which did not respond to repeated taps, was treated with subdural-pleural shunt operation using nonvalve silicone catheters. After a mean follow-up time of 3 years 4 months, 17 patients (77%) were mentally and 15 patients (69%) neurologically normal. The results are certainly not worse than results achieved with craniotomies and membranectomies. A shunt operation is more simple and less hazardous than membranectomy and we agree with the opinion that the latter is an obsolete procedure in the treatment of persistent subdural effusions.

Cerebrospinal Fluid Shunts↗
PubMed1998

Local hypercoagulative activity precedes hyperfibrinolytic activity in the subdural space during development of chronic subdural haematoma from subdural effusion.

The involvement of coagulation and fibrinolysis in the development of chronic subdural haematoma (CSH) from subdural effusion was investigated. Subdural fluid and venous blood samples were obtained from 34 patients with CSH and 9 patients with subdural effusion, and analyzed using enzyme-linked immunosorbent assays for thrombin-antithrombin III complex (TAT), prothrombin fragment F1 + 2 (F1 + 2), tissue factor, tissue factor pathway inhibitor (TFPI) and D-dimer. CSH was classified into the layering type, believed to be active, and other types according to x-ray computed tomography. All markers in the blood of both patient groups were similar to the values of normal subjects. Levels of TAT and F1 + 2 were much higher in the subdural fluid than in the blood of patients with CSH (P < 0.001, P < 0.001) and with subdural effusion (P < 0.05, P < 0.05). The level of D-dimer in the subdural fluid was significantly higher than in the blood (P < 0.001) in patients with CSH, but not in patients with subdural effusion. All markers in the subdural fluid of layering type CSH, except TFPI, were significantly higher than in the other types (P < 0.05). Local hypercoagulative activity in the subdural space is present in subdural effusion and precedes hyperfibrinolytic activity in CSH. Thrombin generation as indicated by TAT and F1 + 2 might be involved in the development of CSH. Propagation of CSH may be modulated by the coagulation system including the extrinsic pathway and fibrinolysis.

Adult↗
PubMed1993

Chronic subdural hematoma may be preceded by persistent traumatic subdural effusion.

The incidence of traumatic subdural effusion (TSE) was analyzed to clarify the relationship with subsequent chronic subdural hematoma (CSH) in 500 patients with head injury evaluated over a 36-month period. TSE occurred in 108 patients (21.6%), and CSH developed in 29 (5.8%) of these. The incidence of TSE was high, although only hospitalized patients were included because of the necessity for serial computed tomography. TSE frequently developed into CSH, and all CSH followed TSE. Therefore, TSE is closely associated with CSH and subdural effusion is probably a preliminary stage necessary for the formation of CSH.

Adolescent↗
PubMed2000

Hemorrhagic subdural effusion complicating an endoscopic III ventriculostomy.

Subdural effusion, a common postoperative complication of extracranial shunting for hydrocephalus, is usually caused by excessive drainage of cerebrospinal fluid. Subdural effusion is thought to occur less frequently after a neuroendoscopic III ventriculostomy, and no reported cases have been symptomatic. We encountered a symptomatic subdural effusion with a component of hemorrhage 5 days after the latter procedure was performed to treat massive hydrocephalus in a 2-year-old boy.

Brain↗
PubMed2006

Unilateral traumatic posterior fossa subdural effusion in an infant.

Supratentorial subdural effusion is common after infection and trauma, but rarely occurs in the posterior fossa, and is even less commonly unilateral. The authors report a rare case of unilateral traumatic posterior fossa subdural effusion with secondary hydrocephalus. A 6-month-old female infant presented with lethargy, poor appetite, and persistent vomiting after head trauma 2 weeks previously. A non-enhanced brain CT scan revealed a right posterior fossa subdural fluid collection that displaced the fourth ventricle and brainstem and dilated lateral ventricles. While monitoring the intracranial pressure, the baby was treated with temporary external subdural drainage, followed by a permanent subdural peritoneal shunt. The treatment and likely physiopathology of this unique case are discussed.

Craniocerebral Trauma↗
PubMed2004

Cerebral venous sinus thrombosis manifesting as bilateral subdural effusion.

Three patients with bilateral subdural effusion, an exclusive manifestation of cerebral venous sinus thrombosis (CVST), are presented. A possible explanation of this rare occurrence is provided, and the differential therapeutic strategies are discussed. We propose to consider CVST in cases of subdural effusions of obscure origin. Appropriate imaging studies should not be delayed if there is suspicion of sinus thrombosis to enable adequate therapy to be started as soon as possible.

Aged↗
PubMed1997

[Subdural effusions in children. Pathophysiology and treatment].

Nine children harboring subdural effusions were treated by subduro peritoneal shunt. These patients were followed-up by CT scans. The area of the subdural effusions was measured by quantitative morphology with a planimeter. With the surgical treatment, the subdural effusion disappeared completely or near completely in 8 patients. The patient's functional state were excellent in 4, good in 3 and bad in 2 in the postoperative follow-up. We aldo reviewed the literature as far as the pathophysiology and the treatment of the subdural effusions are concerned.

Cerebrospinal Fluid Shunts↗
PubMed2006

Surgical treatment outcomes in subdural effusion: a clinical study.

OBJECTIVE: In this study, patients who underwent surgery due to subdural effusion were retrospectively analyzed. The location, depth and etiology of the subdural effusion, the surgical approach that was used and the recurrence rates were studied in these patients. METHOD: A total of 32 patients who were followed up and treated for subdural effusion at the Neurosurgery Clinic of the Yüzüncü Yil University School of Medicine were included in the study; 18 (56%) of the patients were male and 14 (44%) were female. The surgical techniques applied were surgical burr hole drainage, repeated subdural transaxial puncture and subduroperitoneal shunt approaches. The patients were evaluated by computerized tomography of the brain in week 1 and in the third month after surgery. Recurrences were evaluated based on radiological findings and the clinical condition of the patients. RESULT: The consciousness level of the patients was proportional to the mass effect of the subdural effusion. Lower recurrence rates were found in patients with a large midline shift resulting from the subdural effusion. In addition, recurrence rates were higher in patients with cerebral atrophy and lower protein content in the subdural effusion fluid. It was observed that these patients responded better to the subduroperitoneal shunt treatment.

Cerebrospinal Fluid Shunts↗
PubMed1980

Malignant subdural effusion. A case report.

A case of subdural effusion caused by carcinomatous metastatic dural deposits is presented. An attempt is made to explain the possible underlying pathophysiological mechanism of malignant subdural haemorrhagic effusion. Whenever malignant subdural effusion is suspected, biopsy of the membrane and cytological examination of the fluid is imperative for a definite diagnosis.

Carcinoma↗
PubMed1994

Extracerebral fluid collections in infancy: role of magnetic resonance imaging in differentiation between subdural effusion and subarachnoid space enlargement.

The pathological process of extracerebral fluid collections in infancy includes subdural effusion and enlargement of the subarachnoid spaces. Both conditions have traditionally been investigated as a single clinical entity, because of difficulty in differentiating between them. The prognosis of subdural effusion is not as benign as that of enlargement of subarachnoid spaces, requiring differential diagnosis between these disorders. The present study was conducted to elucidate whether this differentiation could be made on magnetic resonance (MR) images. The series consisted of 16 infants aged 10 months or younger, including eight with verified subdural effusion and eight in whom a diagnosis of enlargement of the subarachnoid spaces was achieved by neuroimaging studies other than MR imaging. In all eight patients with subdural effusion, the intensity of the fluid was greater than that of cerebrospinal fluid (CSF) in at least one of the sequences using T1-weighted, proton-density, and T2-weighted MR images. The flow-void sign, indicating vessels in the fluid spaces, was not seen in any of these eight patients. On the other hand, in all eight patients with enlargement of the subarachnoid spaces, the fluid was isointense in relation to CSF, and vascular flow-void areas were seen in at least one of the MR imaging sequences. Based on these observations, it is concluded that differentiation between subdural effusion and enlargement of the subarachnoid spaces can be established by focusing on two aspects of MR imaging findings: 1) the intensity of the fluid, which is either iso- or hyperintense relative to CSF, and 2) the presence or absence of vascular flow-void areas in the fluid spaces.

Contrast Media↗
PubMed1998

Treatment of subdural effusion with hydrocephalus after ruptured intracranial aneurysm clipping.

OBJECTIVE: This study was conducted to determine whether a ventriculoperitoneal shunt alone was effective in treating subdural effusion with hydrocephalus. METHODS: Using only a ventriculoperitoneal shunt, we successfully treated eight patients who had subdural effusion with hydrocephalus after ruptured intracranial aneurysmal clipping, despite ventricular deformity and midline shift. RESULTS: For all of the patients, both the subdural effusion and ventriculomegaly subsided and clinical symptoms lessened after surgery. CONCLUSION: Ventriculoperitoneal shunting alone is an effective and satisfactory procedure; no subdural peritoneal shunt is needed for patients with subdural effusion accompanied by hydrocephalus. To-and-fro communication between the subdural effusion and ventricles is considered to be present in these patients. When selecting the treatment for subdural effusion, it is important to consider whether hydrocephalus (disturbance of cerebrospinal fluid circulation) is present.

Adult↗
PubMed2003

[A case presenting with hydrocephalus and posterior fossa subdural effusion].

We report a case of hydrocephalus due to posterior cranial fossa subdural effusion. The patient was a 4-year-old boy, presenting headache and nausea, with a medical history of viral meningitis 2 months before. Cerebrospinal fluid provided no evidence of infection, and symptoms caused by increased intracranial pressure gradually deteriorated, although glycerol infusion was effective temporarily. Computed tomography revealed marked ventriculomegaly with subdural effusion in the right posterior cranial fossa. The subarachnoid space in the posterior fossa was very tight, and the cerebellum and brain stem were compressed anteriorly. Magnetic resonance imaging demonstrated stenosis of the aqueduct and foramens of Luschka and Magendie. The cerebeller tonsil was dislocated inferiorly, indicating impending herniation, so an emergency operation was performed. Ventriculoperitoneal shunt was undertaken after implantation of an Ommaya reservoir for the posterior fossa subdural effusion. The patient's postoperative course was uneventful, and the symptoms were improved. Although hydrocephalus and subdural effusion following viral meningitis is rare, neuroimaging studies such as CT and MRI should be examined when a young child suffers from symptoms of increased intracranial pressure.

Catheters, Indwelling↗
PubMed1980

Subdural effusions in children under two years--clinical and computer-tomographical data.

We investigated 161 children under 24 months of age by CT of the skull and reviewed the anamnestic and clinical history. 87 children showed subdural effusions, and 74 did not. There were 33 patients with other pathological findings in CT, and 41 had normal scans. Age and sex distribution as well as localization of the subdural effusions were consistent with the literature. The 87 children with subdural effusions represented 1.7% in a sample of about 5.000 CT scans. CT was the most reliable method for diagnosis of subdural effusions, compared to other techniques. There was a preponderance of small subdural effusions from 1 to 7 mm thickness (51%). Other CT abnormalities accompanying subdural effusions were found. Most frequently the interhemispheric sulcus was dilated and an internal hydrocephalus was present. Also in our group there were 7 anamnestical and 6 clinical symptoms highly diagnostic of subdural effusions.

Female↗
PubMed1984

Effect of temporary subdural-peritoneal shunt on subdural effusion with subarachnoid effusion.

A special entity called subdural effusion with ruptured subarachnoid effusion, which was diagnosed by CT, air study, and RI cisternography, was observed in 14 children of up to 10 months of age. 10 cases that showed symptoms of increased intracranial pressure (ICP) were treated by temporary subdural-peritoneal (S-P) shunt, and the remaining 4 cases that showed no symptoms of increased ICP were treated conservatively. 9 of the 10 cases treated by S-P shunt and 2 of the 4 cases treated conservatively showed good results. Poorly balanced absorption of cerebrospinal fluid (CSF) during the special transitional period of the CSF dynamics may be thought to be a pathogenetic factor.

Cerebral Cortex↗