Surgical Pathology of Subdural Hematoma

Munro, Donald

doi:10.1001/archneurpsyc.1936.02260010074005

Cited by 98 publications

(12 citation statements)

References 7 publications

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“…The effects of the hemorrhage on the brain (e.g., compression, herniation, shift) are noted in the autopsy report. Microscopic sections help confirm and document gross findings and may be useful for assessment of the stage of healing (21,22).…”

Section: Discussionmentioning

confidence: 99%

National Association of Medical Examiners Position Paper: Recommendations for the Postmortem Assessment of Suspected Head Trauma in Infants and Young Children

Gill

Andrew

Gilliland

et al. 2014

Academic Forensic Pathology

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The National Association of Medical Examiners convened a panel to create a position paper for recommendations for the investigation of infant deaths due to inflicted head trauma. The correct certification of both the cause and manner of death is dependent upon an evaluation of all available data including information derived from the investigation, scene, postmortem examination, and ancillary studies. This paper provides recommendations for the forensic pathologist on what constitutes the dataset to be produced during the postmortem examination of infants who have died of, or have apparently died of, inflicted head trauma. Specifically, this paper describes 1) procedures, 2) ancillary laboratory tests, and 3) forms of documentation that are important in the investigation of these deaths. The evaluation and documentation of such infant deaths involves the production of a detail oriented and thoroughly documented examination that is independently reviewable to support the multitude of inquiries that may follow from the public and the criminal justice system.

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Section: Discussionmentioning

confidence: 99%

National Association of Medical Examiners Position Paper: Recommendations for the Postmortem Assessment of Suspected Head Trauma in Infants and Young Children

Gill

Andrew

Gilliland

et al. 2014

Academic Forensic Pathology

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“…Several theories h av e been p resen ted in th e lite ra tu re concerning th e form atio n of fluid in a su b d u ra l h em ato m a. W hile M unro and M erritt [11] believe t h a t th e chronic h e m ato m a rep resen ts a continous tra n sitio n from an acu te tra u m a , P utnam [14], Peters [13], Ziilch [22] an d o th ers suggest th a t th e m orphologically wide cap su lar vessels m ig h t cause rep eated hem orrhages. Gardner [7] and Zollinger and Gross [21] p ro v e d in th e ir ex p erim en ts th a t th e capsule behaves as a sem iperm eable m em b ran e; th e la te ap p earan ce of pressure sym ptom s, is due to liq u o r diffusion.…”

Section: Discussionmentioning

confidence: 99%

“…T h u s Tonnis [16], Peters [13] an d re c e n tly W o lf [11] presum e cran ial com pensation w hich la te r b reak s dow n. Since th e first p u b licatio n o f P utnam and Cushing [14], m a n y a u th o rs presum e fu rth e r hem orrhages from th e d ilated c ap su lar vessels. Gardner's osm otic th eo ry [7] explains the filling u p of th e h e m a to m a capsule by the diffusion o f cerebrospinal fluid.…”

Section: Holinesterase In S Ubdural H E M Ato M As B Y D a F R A Amentioning

confidence: 99%

Cholinesterase in Subdural Hematomas

Afra¹,

Wollemann²

1965

Stereotact Funct Neurosurg

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“…Magnetic imaging studies have found that perinatal SDHs are no longer detectable on imaging after three months of age (26). Organized subdural membranes, however, may be seen pathologically well beyond three months (6,27,28).…”

Section: Mccubbin Et Al • Page 219mentioning

confidence: 99%

Subdural Hemorrhage and Hypoxia in Children Less than Two Years Old

McCubbin

Thoma²,

Mena

et al. 2013

Academic Forensic Pathology

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The majority of subdural hemorrhages (SDH) are due to acceleration-deceleration forces associated with blunt head injury. So-called spontaneous subdural hemorrhages are described with coagulopathies, hemodialysis, hemophilia, and as extensions of hemorrhages due to other causes such as ruptured cerebral artery aneurysms. Recently, some have proposed that hypoxia causes subdural hemorrhage in infants and children. Materials and Methods: Of 1,190 deaths of children younger than two years of age, we analyzed 366 that were due to asphyxial mechanisms, respiratory disease, prematurity, seizures, and perinatal hypoxic-ischemic encephalopathy. All underwent autopsy and 97% included a consultant neuropathology examination. Results: Of the 366 decedents, hypoxic-ischemic encephalopathy (HIE) was diagnosed in 73 (20%) and evidence of subdural hemorrhage in 34 (9%). Of the 73 HIE deaths, 14 (19%) had SDH. Among these 14, 12 involved prematurity and/or perinatal HIE. Among the 20 fatalities with SDHs but without HIE, all were premature infants and/or had a SDH that pathologically pre-dated the putative hypoxic-ischemic event. Of the 34 SDHs, 24 were organized neomembranes and ten were organizing hemorrhages. Discussion: SDHs that are not caused by acceleration-deceleration forces are routinely recognized in infants and children. Usually, they are clinically silent and may be associated with prematurity and perinatal birth events. At autopsy, subdural neomembranes frequently are incidental findings in infants and children who die from a variety of causes. This study does not support the theory that hypoxic-ischemic injury in infants and children causes subdural hemorrhage.

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Surgical Pathology of Subdural Hematoma

Cited by 98 publications

References 7 publications

National Association of Medical Examiners Position Paper: Recommendations for the Postmortem Assessment of Suspected Head Trauma in Infants and Young Children

National Association of Medical Examiners Position Paper: Recommendations for the Postmortem Assessment of Suspected Head Trauma in Infants and Young Children

Cholinesterase in Subdural Hematomas

Subdural Hemorrhage and Hypoxia in Children Less than Two Years Old

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