Isodense Acute Subdural Hematoma

Kaufman, Howard H.; Singer, Joel M.; Sadhu, Vijay K.; Handel, Stanley F.; Cohen, Gerald

doi:10.1097/00004728-198008000-00034

Cited by 23 publications

(7 citation statements)

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“…Associated membranes may enhance with intravenous contrast, which can be useful in preoperative planning [70]. The radiographic characteristics of cSDH have been previously extensively reviewed [40,41,99].…”

Section: Pathophysiology Of Csdhmentioning

confidence: 99%

The surgical management of chronic subdural hematoma

et al. 2011

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Chronic subdural hematoma (cSDH) is an increasingly common neurological disease process. Despite the wide prevalence of cSDH, there remains a lack of consensus regarding numerous aspects of its clinical management. We provide an overview of the epidemiology and pathophysiology of cSDH and discuss several controversial management issues, including the timing of post-operative resumption of anticoagulant medications, the effectiveness of anti-epileptic prophylaxis, protocols for mobilization following evacuation of cSDH, as well as the comparative effectiveness of the various techniques of surgical evacuation. A PubMed search was carried out through October 19, 2010 using the following keywords: "subdural hematoma", "craniotomy", "burr-hole", "management", "anticoagulation", "seizure prophylaxis", "antiplatelet", "mobilization", and "surgical evacuation", alone and in combination. Relevant articles were identified and back-referenced to yield additional papers. A meta-analysis was then performed comparing the efficacy and complications associated with the various methods of cSDH evacuation. There is general agreement that significant coagulopathy should be reversed expeditiously in patients presenting with cSDH. Although protocols for gradual resumption of anti-coagulation for prophylaxis of venous thrombosis may be derived from guidelines for other neurosurgical procedures, further prospective study is necessary to determine the optimal time to restart full-dose anti-coagulation in the setting of recently drained cSDH. There is also conflicting evidence to support seizure prophylaxis in patients with cSDH, although the existing literature supports prophylaxis in patients who are at a higher risk for seizures. The published data regarding surgical technique for cSDH supports primary twist drill craniostomy (TDC) drainage at the bedside for patients who are high-risk surgical candidates with non-septated cSDH and craniotomy as a first-line evacuation technique for cSDH with significant membranes. Larger prospective studies addressing these aspects of cSDH management are necessary to establish definitive recommendations.

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Section: Pathophysiology Of Csdhmentioning

confidence: 99%

The surgical management of chronic subdural hematoma

et al. 2011

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“…This has been propagated in the literature without strong evidence. Many of the previous articles that described hypodense acute subdural hematomas are cases that are several decades old . There are several possible reasons to account for their findings.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several case reports in the literature of acute subdural hematomas isodense to brain parenchyma due to anemia . Acute subdural hematomas hypodense to brain parenchyma has also been described in the setting of severe anemia .…”

Section: Introductionmentioning

confidence: 99%

CT Attenuation of Acute Subdural Hematomas in Patients with Anemia

Duy

Badeeb

Duy

et al. 2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: Isodense and hypodense acute subdural hematomas have been reported in the literature in anemic patients. The purpose of this study is to see if there is a statistically significant difference between the Hounsfield unit measurements of acute subdural hematomas in anemic and nonanemic patients. METHODS: A total of 109 patients were analyzed. We measured the most hyperdense component of the subdural hematoma and compared these measurements for both anemic and nonanemic patients. RESULTS:All patients with anemia had a hyperdense component to their subdural hematomas during the acute period. No statistically significant difference was found in the density of the subdural hematomas between the two groups. More heterogeneous subdural hematomas were found in the anemic group than the nonanemic group, which suggests that anemia alone is not a sufficient explanation for acute homogenous isodense and hypodense subdural hematomas. CONCLUSION: A hyperdense subdural component was present in all acute subdural hematomas in anemic patients. Therefore, anemia alone is not a sufficient explanation for a homogenous low-density acute subdural hematoma.Acknowledgments: This project received no funding. The study had an institutional IRB approval. Conflicts of Interest:The authors declare no conflicts of interest.

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“…43 Subarachnoid hemorrhage is detected readily on noncontrast CT as hyperdense blood filling the subarachnoid space within cortical sulci or basilar cisterns. [65][66][67] Hyperdense blood can be seen from the time of injury to as long as 7 to 10 days after the traumatic event. 50,51 Intraventricular hemorrhage can result from primary rupture of subependymal veins, or either reflux of subarachnoid hemorrhage or dissection of an intracerebral hematoma into the ventricles.…”

Section: Extraaxial Injury In Abusive Head Traumamentioning

confidence: 99%

Imaging of Abusive Head Trauma

Tung¹

2011

Child Abuse and Neglect

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Isodense Acute Subdural Hematoma

Cited by 23 publications

References 0 publications

The surgical management of chronic subdural hematoma

The surgical management of chronic subdural hematoma

CT Attenuation of Acute Subdural Hematomas in Patients with Anemia

Imaging of Abusive Head Trauma

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