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Delayed epidural hematoma after mild head injury  [PDF]
Radulovi? Danilo,Jano?evi? Vesna,Raki? Miodrag,?urovi? Branko
Vojnosanitetski Pregled , 2005, DOI: 10.2298/vsp0509679r
Abstract: Background. Traumatic delayed epidural hematoma (DEH) can be defined as insignificant or not seen on the initial CT scan performed after a trauma but seen on the subsequent CT scan as a “massive” epidural bleeding. Case report. We presented two cases of traumatic DEH after mild head injury. Both patients were conscious and without neurological deficit on the admission. Initial CT scan did not reveal intracranial hematoma. Repeated CT scan, that was performed after neurological deterioration, revealed epidural hematoma in both cases. The patients were operated with a favorable surgical outcome. Conclusion. Traumatic DEH could occur in the patients with head injuries who were conscious on the admission with a normal initial CT scan finding. Early detection of DEH and an urgent surgical evacuation were essential for a good outcome.
Epidemiological Analysis of Surgically Treated Acute Traumatic Epidural Hematoma  [PDF]
Aurelien Ndoumbe, Martine Virginie Patience Ekeme, Bonaventure Jemea, Chantal Simeu, Samuel Takongmo
Open Journal of Modern Neurosurgery (OJMN) , 2016, DOI: 10.4236/ojmn.2016.63016
Abstract: This study is a retrospective analysis of demographic, clinical, radiological and outcome data of surgically treated acute traumatic epidural hematomas. Forty-six consecutive cases of epidural hematomas were operated at the University Hospital Center of Yaoundé, Cameroon, between February 2006 and December 2013. The mean age was 29.56 years and63.04% of patients were between 21 and 30 years. Almost 94% of patients were males. Thirty-five percent of patients were motorcycle riders. Road traffic accident was the cause in 70% of cases. Mean time between head trauma and surgical evacuation was 78 hours. Head trauma was moderate in 52.17%. Initial loss of consciousness was found in 78.26% and lucid interval in 65.23%. Seventy-four percent of patients had signs of intracranial hypertension on admission, 35% had at least one neurologic focal sign and 50% had a scalp wound. Eight patients (17.39%) presented with unilateral or bilateral mydriasis. On computed tomography, the hematoma was on the left side in 60.86% of patients and frontal-parietal location was the most frequent. Computed tomography showed mass effect in 97.82% of patients. The most frequent surgical procedure was craniotomy. Six (13.04%) patients died, but 82.60% recovered fully (GOS 5). In Cameroon, traumatic acute epidural hematoma affects primarily healthy young men in their twenties and thirties. Road traffic accidents are the main etiology. Most patients had moderate head trauma and presented with intracranial hypertension. Early surgery is rarely done. Nevertheless, even with delayed surgery, most patients have good outcome.
Delayed traumatic spinal epidural hematoma with neurological deficits  [PDF]
Luciano Miller Reis Rodrigues,Felipe Abreu,Edison Noboru Fujiki,Carlo Milani
Einstein (S?o Paulo) , 2010,
Abstract: To describe the mechanism that causes spinal epidural hematoma with neurologic deficit and review the literature. We report a case of a 62-year-old man with post-traumatic epidural hematoma in the cervicothoracic spine, who developed progressive neurological deficit which eventually resulted in complete paralysis below T1. During surgical evacuation significant spine compression due to an organizing hematoma was observed. After surgery, the patient’s motor function improved and there was a complete recovery of the neurologic deficit after a rehabilitation program. Conclusion: Epidural hematoma can happen after delayed traumatic event leading to a variable degree of neurologic damage.
Epidural hematomas of posterior fossa  [PDF]
Radulovi? Danilo,Tasi? Goran,Jokovi? Milo?
Vojnosanitetski Pregled , 2004, DOI: 10.2298/vsp0402133r
Abstract: Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT) and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.
Acute Epidural Hematoma Compressing the Dominant Sigmoid Sinus as an Unusual Cause of Intracranial Hypertension: Case Report and Review of Literature  [PDF]
Gustavo Rajz, Ido Ben Zvi, Shalom Michowiz, José E. Cohen
Open Journal of Modern Neurosurgery (OJMN) , 2014, DOI: 10.4236/ojmn.2014.42016
Abstract: Post traumatic dural sinus vein stenosis has been rarely described in pediatric population. We present a case of a 9-year-old child that had sustained a head injury after a fall from height causing an acute epidural hematoma compressing the dominant sigmoid sinus. The patient had developed sub acutely signs and symptoms of increased intracranial pressure. Prophylactic treatment with anticoagulants was initiated despite the presence of an intracranial bleeding. Clinical and radiological improvements were achieved. We had also reviewed the literature regarding this uncommon entity and discussed other existing diagnostic and therapeutic alternatives. Further gathering of information is essential in order to form a therapeutic protocol.
Hematoma extradural do vértex: relato de caso
Haikel Jr., Luiz Fernando;Listik, Sérgio;Rodrigues Jr., José Carlos;Viterbo, Marcelo B. Soares;Pereira, Clemente A. Brito;
Arquivos de Neuro-Psiquiatria , 2005, DOI: 10.1590/S0004-282X2005000200032
Abstract: we report the unusual case of a 37 years old man with an epidural traumatic hematoma at the vertex with intracranial hypertension symptoms. the diagnostic was achieved with coronal cranial tomographic scans and a craniotomy was performed for hematoma removal.
Epidural Hematoma In The Newborn Infant : A Case Report  [PDF]
Aslihan KOSEOGLU,Ahmet DAGTEKIN,Aziz OZKAN,Engin KARA
Journal of Neurological Sciences , 2010,
Abstract: Traumatic epidural hematoma (EDH) represents a rare head injury complication in the newborn. EDH is seen in 2-3 % of all head injuries in the pediatric population. A case of epidural hematoma by an accidental trauma due to the dropping of the patient to the labor room floor was reported. The male newborn's birth weight was 2650 gr. His neurologic examination revealed left hemiparesis. A solid epidural hematoma was recognized on Computed Tomography (CT). The hematoma was decompressed surgically. He was discharged from the hospital at the 3th day. The treatment of the newborn EDH is controversial. Treatment may be conservative, surgical or interventional needle aspiration. Etiology and treatment of the newborn EDH are discussed.
Traumatic bilateral intraorbital (subperiosteal) hematoma associated with epidural hematoma: case report
Costa Jr, Leodante Batista da;Andrade, Agustinho de;Henriques, José Gilberto de Bastos;Cordeiro, Anderson Finotti;Maciel, Cícero do Juazeiro Job;
Arquivos de Neuro-Psiquiatria , 2003, DOI: 10.1590/S0004-282X2003000600030
Abstract: extradural hematoma (edh) is a frequent lesion, with an incidence varying from 0.2 to 6% in patients admitted to hospital due to traumatic head injury. the higher incidence is found in patients with more severe injuries. the association of edh with subperiosteal intraorbital hematomas is rarely reported, and we were not able to find in the literature any report of traumatic bilateral intraorbital hematomas and edh. we report this case of a 32 year-old man with bilateral intraorbital (subperiosteal) hematoma associated with unilateral edh. the lesions were treated surgically, but unfortunately with an unfavorable outcome.
Traumatic bilateral intraorbital (subperiosteal) hematoma associated with epidural hematoma: case report
Costa Jr Leodante Batista da,Andrade Agustinho de,Henriques José Gilberto de Bastos,Cordeiro Anderson Finotti
Arquivos de Neuro-Psiquiatria , 2003,
Abstract: Extradural hematoma (EDH) is a frequent lesion, with an incidence varying from 0.2 to 6% in patients admitted to hospital due to traumatic head injury. The higher incidence is found in patients with more severe injuries. The association of EDH with subperiosteal intraorbital hematomas is rarely reported, and we were not able to find in the literature any report of traumatic bilateral intraorbital hematomas and EDH. We report this case of a 32 year-old man with bilateral intraorbital (subperiosteal) hematoma associated with unilateral EDH. The lesions were treated surgically, but unfortunately with an unfavorable outcome.
Non-surgical management of intracranial subdural hematoma complicating spinal anesthesia
Verdú,M.T.; Martínez-Lage,J.F.; Alonso,B.; Sánchez-Ortega,J.L.; Garcia-Candel,A.;
Neurocirugía , 2007, DOI: 10.4321/S1130-14732007000100005
Abstract: we report the case of a 29 year-old woman who presented a symptomatic intracranial subdural hematoma developing shortly after spinal anesthesia. the patient was fully conscious at clinical onset, and thus we treated her conservatively with an epidural autologous blood patch and close neurological observation. given the clinical improvement the possibility of surgery was discauded in agreement with the neurosurgical team. most cases of subdural hematoma appearing after spinal anesthesia are treated with surgery. in the present case the subdural hemorrhage was detected at our hospital 20 days after the anesthetic procedure, and given the excellent state of consciousness, we choosed a conservative management.
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