Spontaneous Intracranial Hypotension Associated With Bilateral Chronic Subdural Hematomas. Case Report.

Murakami, Mineko; Morikawa, Kaoru; Matsuno, Akira; Kaneda, Kenshi; Nagashima, Tadashi

doi:10.2176/nmc.40.484

Cited by 24 publications

(19 citation statements)

References 23 publications

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“…4 8 A review of published reports revealed a few cases of SIH complicated by small subdural collections which required neurosurgical drainage. [9][10][11][12][13][14] However, there are no records of large subdural haematomas causing a decreased conscious level and requiring urgent neurosurgical drainage. This study was undertaken to assess the incidence of this serious complication of SIH.…”

mentioning

confidence: 99%

Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension

Noronha

Sharrack²,

Hadjivassiliou³

et al. 2003

Journal of Neurology, Neurosurgery &Amp; Psychiatry

140

109

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Background: Spontaneous intracranial hypotension (SIH) is characterised by postural headache and low opening pressure at lumbar puncture without obvious cause. Cranial magnetic resonance imaging often shows small subdural collections without mass effect, dural enhancement, venous sinus dilatation, or downward displacement of the brain. The condition is thought to be benign. Objectives: To evaluate the incidence of subdural haematoma as a serious complication of SIH. Methods: A prospective survey of all cases of SIH presenting to a large neuroscience unit over a two year period. Results: Nine cases of SIH were seen. Four of these were complicated by acute clinical deterioration with reduced conscious level because of large subdural haematomas requiring urgent neurosurgical drainage. Conclusions: SIH should not be considered a benign condition. Acute deterioration of patients' clinical status may occur secondary to large subdural haematomas, requiring urgent neurosurgical intervention.

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mentioning

confidence: 99%

Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension

Noronha

Sharrack²,

Hadjivassiliou³

et al. 2003

Journal of Neurology, Neurosurgery &Amp; Psychiatry

140

109

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“…Standard approaches include craniostomy by either burr hole or twist drill, evacuation of the hematoma with or without irrigation and in most instances drainage. Defenders of drainage argued that this latter will allow brain expansion by progressive evacuation of residual fluid after spontaneous evacuation or irrigation of the cavity; also it seems to diminish early complications (42,44,(46)(47)(48)(50)(51)(52). Since the mid of the 80's, all series reporting treatment with drainage used a system of closed-drainage.…”

Section: Discussionmentioning

confidence: 99%

“…The most surgical techniques used are craniostomy by burr hole or twist drill with or without irrigation, and with or without drainage (2,4,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). Drainage seems to be a must for several authors (42,(44)(45)(46)(47)(48)(49)(50)(51)(52). Closed system drainage is used since the mid of the 80's because open drainage had been incriminated in high rates of infection (53)(54)(55)(56).…”

Section: Background and Importancementioning

confidence: 99%

Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

Bakhti

Tighilt

Djennas

2016

IrJNS

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Background & Importance: Chronic subdural hematoma (CSH) is one of the most frequent intracranial hemorrhages in adults. However, gold standard treatment of CSH is not yet defined. Since the 80's, closed drainage is a standard among techniques using drains because the open type has been incriminated in high rates of postoperative infections. However, closed drainage requires materiel which is sometimes not available or expensive in some countries. Open drainage was reintroduced in our department in the middle of the 90's because of economic crisis at this time. We have then conducted a prospective study to assess safety and efficacy of open drainage in treatment of CSH.Case Presentation: A prospective study of adult patients with CSH was conducted from January 2008 to December 2011. All patients have the same surgical procedure which included one burr-hole craniostomy, spontaneous evacuation and open drainage. The study focused on infectious complications, postoperative seizures, and recurrences. Results are compared with those of literature. In our study, 189 patients were operated with mean age of 69.2 years old. Of all, 163 patients were cured. Overall rate of complications was 15.34% with an infection rate of 1.58%, a postoperative seizure rate of 1.05% and a recurrence rate of 14.2%. Mortality rate was 5.8%. Results were in concordance with those of large series of literature. Conclusion:Data of the current study suggested that open drainage is a safe and efficient method in treatment of CSH. It is also a costefficient treatment that could be very interesting for middle-and low-income countries. Keywords AbstractBackground and Importance

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“…Certain pre-morbid conditions, i.e. sufficient potential subdural space such as arachnoid cyst, brain atrophy, or intracranial hypotension with or without head injury, 13,19,22) are prerequisites for the occurrence of CSDH. Unresolved subdural hygroma with or without blood induces proliferation of dural border cells by evoking inflammatory reaction and production of neomembranes.…”

Section: Discussionmentioning

confidence: 99%

Effect of Platelet-Activating Factor Receptor Antagonist, Etizolam, on Resolution of Chronic Subdural Hematoma-A Prospective Study to Investigate Use as Conservative Therapy-

Hirashima

Kurimoto

Nagai

et al. 2005

Neurol. Med. Chir.(Tokyo)

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Inflammatory reaction is very important for formation of the neomembrane of chronic subdural hematoma (CSDH). The present study evaluated medical treatment with the platelet-activating factor receptor antagonist, etizolam, for the resolution of CSDH, and the factors indicating surgery or conservative therapy. Alternate patients were assigned to the etizolam group or control group without medical treatment. Patients in the etizolam group received 3.0 mg etizolam per day for 14 days. A total of 53 patients were followed up for at least 6 months. Univariate analysis of differences in demographic characteristics, clinical findings, and initial computed tomography (CT) findings, and multiple logistic regression analysis of the relationship between etizolam treatment and requirement for surgery using age, sex, low density of hematoma on CT, and paresis as confounders were performed. Etizolam treatment (adjusted odds ratio [OR] 0.156, 95% confidence interval [CI] 0.024-0.999, p ＝ 0.049) was negatively correlated with requirement for surgery. Low density of hematoma (adjusted OR 0.125, 95% CI 0.019-0.846, p ＝ 0.033) was found to be an independent negative predictor, and paresis as an initial symptom (adjusted OR 6.35, 95% CI 1.04-38.7, p ＝ 0.045) was an independent positive predictor of requirement for surgery. Etizolam administration can promote the resolution of CSDH, especially at the stage of hygroma appearing as low density on CT. Surgery is recommended if the patient presents with paresis.

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Spontaneous Intracranial Hypotension Associated With Bilateral Chronic Subdural Hematomas. Case Report.

Cited by 24 publications

References 23 publications

Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension

Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension

Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

Effect of Platelet-Activating Factor Receptor Antagonist, Etizolam, on Resolution of Chronic Subdural Hematoma-A Prospective Study to Investigate Use as Conservative Therapy-

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