Chronic subdural hematoma:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Neurosurgery clinics of North America
11,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Einzelaufnahme eines Zeitschr.-H. |
| Beschreibung: | XIV S., S. 395 - 573 Ill., graph. Darst. |
Internformat
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Datensatz im Suchindex
| _version_ | 1804128096398344192 |
|---|---|
| adam_text | CHRONIC SUBDURAL HEMATOMA
CONTENTS
Foreword xvii
Michael L. J. Apuzzo
Preface xix
Hikmat El Kadi and Howard H. Kaufman
A Brief History of Chronic Subdural Hematomas 395
Daniel A. Wecht
Examination of human remains tells us that subdural hematomas have been
with mankind for thousands of years. Their recognition as distinct clinical
entities is considerably more recent, and it has only been in the last century
that the cause of chronic subdural hematomas has been adequately eluci¬
dated. The history of this discovery process is interesting and sheds light
on the nature of scientific progress in general.
Causes, Epidemiology, and Risk Factors of Chronic
Subdural Hematoma 399
Joseph C. T. Chen and Michael L. Levy
Chronic subdural hematoma is an important reversible cause of dementia
and disability in the elderly. A sufficiently high level of clinical suspicion
and prompt radiographic evaluation may allow for timely treatment to
avoid poor outcomes. Thankfully, the routine use of computed tomographic
scanning in most emergency facilities has made the diagnosis of these le¬
sions commonplace.
The Outer Neomembrane of Chronic Subdural Hematoma 407
James A. Killeffer, Fred A. Killeffer, and Sydney S. Schochet
Thomas Willis recognized the entity of the chronic subdural hematoma
(CSH) more than 300 years ago. Modern observations of the infrastructure
of normal meninges and the CSH outer neomembrane, combined with
techniques of radioactive red blood cell labeling and chemical analysis of
NEUROSURGERY CLINICS OF NORTH AMERICA
VOLUME 11 • NUMBER 3 • JULY 2000 jx
CSH fluid, have provided insight into the pathophysiology of this entity.
The outer membrane evolves as a reaction to cleavage of the dural border
cell layer of the meninges. Interaction between the components of the outer
neomembrane and CSH fluid contributes to the growth of the outer mem¬
brane and recurrent hemorrhaging.
The Inner Membrane of Chronic Subdural Hematomas:
Pathology and Pathophysiology 413
Tetsumori Yamashima
There is no clear plane between the dura and arachnoid in situ. Instead of
the virtual subdural space, there is a dura arachnoid interface layer, which
is structurally the weakest throughout the meninges. An extravasation of
blood within the dural border layer splits it, leaving a few tiers of dural
border cells over the arachnoid. These cells cover the internal surface of the
hematoma, proliferate, and later on, form the inner membrane. The outer
membrane is related to hematoma enlargement because of the repetitive
hemorrhages whereas the inner membrane is related to liquification of the
subdural hematoma. As the inner membrane plays a pivotal role in the
pathophysiogenesis and determination of the location of chronic subdural
hematoma, histologic, ultrastructural, and clinical analyses were performed
with correlations to the dura arachnoid interface and the so called sub¬
dural space.
Contents of Chronic Subdural Hematoma 425
Marcus Stoodley and Bryce Weir
Analysis of chronic subdural hematoma membranes and contents has re¬
vealed a complex process of blood breakdown forming a milieu that stimu¬
lates neovascularization and repeated hemorrhage.
Pathophysiology of Evolution and Recurrence of Chronic
Subdural Hematoma 435
Jack E. Wilberger
Although the pathophysiology of the development, propagation, and recur¬
rence of current subdural hematoma remains debatable, fundamental man¬
agement strategies may be formulated to optimize outcomes. Effective drain¬
age by whatever surgical means, removal of offending membranes when
appropriate, and maximization of postoperative physiologic parameters are
based on the best available current pathophysiologic information.
Chronic Subdural Hematoma in Children 439
Dale M. Swift and Lori McBride
Chronic subdural hematoma (CSH) is generally a disease affecting the el¬
derly and infants. In infants, the process is particularly confusing and fre¬
quently misunderstood. In the pediatric population, CSH is just one of a
group of sometimes related conditions known as extracerebral fluid collections.
In the past, extracerebral fluid collections, in general, and CSHs, in particular,
have been inaccurately or incompletely described. Modern neuroimaging
techniques, however, have greatly advanced our understanding of these
conditions. Surprisingly little literature exists on the subject, and publica¬
tions before the advent of modern computed tomography and magnetic
resonance imaging should be interpreted with caution.
X CONTENTS
Chronic Subdural Hematoma in Adult and Elderly Patients 447
Mark R. Iantosca and Richard H. Simon
Chronic subdural hematomas display a wide diversity of features in adults,
often simulating other neurologic and psychiatric disease processes. This
is particularly problematic in elderly patients, for whom more nonspecific
clinical presentations are common. Recognition of these features is the key
to early diagnosis in elderly patients, who exhibit a markedly increased
incidence of this disease. Prompt diagnosis prevents delays that may lead
to increased morbidity in these patients.
Interhemispheric and Bilateral Chronic Subdural Hematoma 455
Ali Sadrolhefazi and Stephen M. Bloomfield
Data on bilateral chronic subdural hematomas (CSHs) are scant, including
information on the frequency of symptoms, response to various treatments, and
postoperative complications, compared with data on unilateral CSH. Bilateral
CSHs constitute a fair portion of CSHs, especially in patients older than 75
years and in those with coagulation abnormalities. The presenting symptoms
are those of increased intracranial pressure and mass effect. Computed tomog¬
raphy of the head is the best study for the diagnosis and follow up of bilateral
CSHs, although magnetic resonance imaging is a more sensitive modality.
Treatment of bilateral CSHs presents its own unique set of problems. New
hemorrhage on the contralateral side and shift of midline structures are con¬
cerns and can be avoided by simultaneous bilateral decompression. Twist
drill craniostomy, burr hole washout, and craniotomy are the mainstays of
treatment, with subdural peritoneal shunting reserved for intractable rases.
Spinal Chronic Subdural Hematoma 465
Adnan A. Abla and Michael Y. Oh
Although chronic subdural hematomas are rare, they are likely to be more
frequently reported as the clinical and magnetic resonance imaging charac¬
teristics become defined. Chronic spinal subdural hematomas (CSSDH) are
extremely rare; these hematomas are frequently spontaneous and related
to minor trauma. Although generally said to carry a poor prognosis, CSSDH
can be a reversible cause of paraplegia. This article reviews the history,
classification, clinical presentation, and treatment of CSSDH.
Clinical Features of Chronic Subdural Hematoma:
Neuropsychiatric and Neuropsychologic Changes in Patients
with Chronic Subdural Hematoma 473
Mary M. Machulda and Marc W. Haut
This article provides a background review of the cognitive and behavioral
symptoms associated with chronic subdural hematoma (CSH). The areas
addressed include the initial cognitive and behavioral symptom presenta¬
tion, lateralization and localizing signs, differences between older and
younger patients, and differential diagnosis. Although it is clear that behav¬
ioral and cognitive abnormalities are seen in CSH, further work is needed
to objectively clarify the range of symptoms and signs.
Computed Tomographic Characteristics of Chronic
Subdural Hematomas 479
Varoujan Kostanian, James C. Choi, Mark A. Liker, John L. Go,
and Chi Shing Zee
Although medical history and physical examination should lead to diagnosis
of chronic subdural hematomas, 40% of these patients are likely to be misdi
CONTENTS X]
agnosed because many of these symptoms occur in other disease processes,
such as transient ischemic attacks, stroke, dementia, and tumors. Computed
tomography remains one of the most useful tools in the evaluation of these
patients because of its rapidity, cost, availability, and pathologic sensitivity.
Magnetic Resonance Imaging of Chronic Subdural Hematoma 491
Vickie L. Williams and Jeffery P. Hogg
This article highlights the unique ability of magnetic resonance imaging in
evaluating the evolution of the subdural hematoma. Topics specifically
discussed are computed tomography sensitivity and the extent, age, and
complexity of the subdural hematoma.
Regional Cerebral Blood Flow and Metabolism in Chronic
Subdural Hematoma 499
Hiroto Kuwabara
There are two hypotheses on how chronic subdural hematoma causes hemi
paresis and other focal neurologic symptoms without, in most cases, leaving
permanent neurologic deficits. One hypothesis is that the reduced regional
cerebral blood flow (rCBF) caused by either compression or distortion of
the local or remote brain tissue is responsible for hemiparesis. The other
hypothesis is that the reduction in rCBF alone is not sufficient to cause
permanent hemiparesis.
Treatment of Chronic Subdural Hematoma by Burr Holes
and Closed System Drainage 503
Zbigniew Kotwica
This article highlights the treatment of choice of chronic subdural hematoma.
The importance, effectiveness, and low complication rate of minimally inva¬
sive procedure by burr holes and closed system drainage is discussed.
Nonoperative Treatment of Chronic Subdural Hematoma 507
Joseph L. Voelker
Chronic subdural hematomas that are asymptomatic or producing only
mild symptoms are occasionally found with current neuroimaging methods.
Some do not progress, and spontaneous resolution can occur. In addition,
successful medical treatment of more significant hematomas has been re¬
ported. The indications for nonoperative management of these lesions are
reviewed in this article.
Twist drill Craniostomy for the Treatment of Chronic
Subdural Hematoma 515
Mark Camel
The choice of the initial surgical method for treating the patient with CSH
is influenced by the patient s neurologic status at the time of presentation,
associated medical factors, and the surgeon s experience in the management
of these patients. The outcome data suggest that twist drill craniostomy
with closed system catheter drainage results in an equivalent or superior
outcome to the historical results of craniotomy with membranectomy. Crani
otomy remains the treatment of choice when the admitting computerized
tomographic scan demonstrates a significant hyperdense component sug¬
gesting the presence of solid or mixed hematoma.
Xii CONTENTS
Percutaneous Subdural Tapping and Subdural Peritoneal
Drainage for the Treatment of Subdural Hematoma 519
Kent L. Sauter
Different therapeutic approaches may be used in the treatment of chronic
subdural hematoma because it is more fluid. Age dependent characteristics
of the calvarium allow for different treatment in children and adults. Treat¬
ment options are discussed.
Neuroendoscopic Treatment of Loculated Chronic
Subdural Hematoma 525
Dieter Hellwig, Stefan Heinze, Thomas Riegel, and Ludwig Benes
Treatment of loculated chronic subdural hematoma using endoscopic
operative techniques combined with closed system draining is a mini¬
mally invasive method and a therapeutic alternative to the craniotomy
membranectomy technique.
The Role of Craniotomy and Trephination in the Treatment of
Chronic Subdural Hematoma 535
Joseph L. Voelker and M. Sambasivan
The treatment of chronic subdural hematoma by craniotomy was the proce¬
dure of choice in the early part of this century. It has since been replaced
by less invasive techniques but retains a limited role in the management
of this condition. A new procedure involving a small craniectomy and
marsupialization of the hematoma cavity to the temporalis muscle is de¬
scribed. The results of this treatment compare favorably with the more
commonly performed drainage methods.
The Course of Chronic Subdural Hematomas After Burr Hole
Craniostomy with and without Closed System Drainage 541
Thomas Marc Markwalder
The author provides a comprehensive review of the results of surgical
treatment of chronic subdural hematomas (CSHs). The postoperative clinical
course of CSH is studied with respect to the influence of neomembranous
organization, cortical expansion, and subdural pressure. The importance of
subdural drainage is emphasized.
Postoperative Complications of Chronic Subdural Hematomas:
Prevention and Treatment 547
Alexander D. Kravtchouk, Leonid B. Likhterman,
Alexander A. Potapov, and Hikmat El Kadi
The treatment of chronic subdural hematoma seems simple and effective;
however, postoperative complications like recurrence of hematoma, pneu
mocephalus brain collapse, and intracervical hemorrhage still occur in some
patients, and these complications are dependent on surgical technique, pa¬
tient s age, and preexisting morbidity.
Prognosis of Chronic Subdural Hematomas 553
Hikmat El Kadi, Vincent J. Miele, and Howard H. Kaufman
This article considers factors that may be of prognostic value in evaluating
the chronic subdural hematoma (CSH) patient. It also examines conditions
that predispose the development of a CSH. Variables such as admission
CONTENTS xiii
neurologic status and presenting symptomatology are reviewed. Radiologic
parameters (i.e., CSH density and midline shift) and intraoperative findings
(i.e., pressure and pulse) are discussed.
Index 569
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Xiv CONTENTS
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| spelling | Chronic subdural hematoma Hikmat El-Kadi ..., guest eds. Philadelphia [u.a.] Saunders 2000 XIV S., S. 395 - 573 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Neurosurgery clinics of North America 11,3 Einzelaufnahme eines Zeitschr.-H. Subdurales Hämatom (DE-588)4193814-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Subdurales Hämatom (DE-588)4193814-8 s DE-604 El-Kadi, Hikmat Sonstige oth Neurosurgery clinics of North America 11,3 (DE-604)BV002758938 11,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009085707&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Chronic subdural hematoma Neurosurgery clinics of North America Subdurales Hämatom (DE-588)4193814-8 gnd |
| subject_GND | (DE-588)4193814-8 (DE-588)4143413-4 |
| title | Chronic subdural hematoma |
| title_auth | Chronic subdural hematoma |
| title_exact_search | Chronic subdural hematoma |
| title_full | Chronic subdural hematoma Hikmat El-Kadi ..., guest eds. |
| title_fullStr | Chronic subdural hematoma Hikmat El-Kadi ..., guest eds. |
| title_full_unstemmed | Chronic subdural hematoma Hikmat El-Kadi ..., guest eds. |
| title_short | Chronic subdural hematoma |
| title_sort | chronic subdural hematoma |
| topic | Subdurales Hämatom (DE-588)4193814-8 gnd |
| topic_facet | Subdurales Hämatom Aufsatzsammlung |
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