Transient neurologic deficit caused by chronic subdural hematoma

Kaminski, Henry J.; Hlavin, Mary Louise; Likavec, Matt J.; Schmidley, James W.

doi:10.1016/0002-9343(92)90790-i

Cited by 33 publications

(24 citation statements)

References 8 publications

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“…ischemia in the brain. There are numerous other nonischemic causes of sudden, transient, focal neurologic deficits [4, 5, 6, 7, 8, 9, 10]. Proof of an ischemic cause should impact on the strength of TIA as a risk factor for clinical stroke.…”

Section: Introductionmentioning

confidence: 99%

‘Footprints’ of Transient Ischemic Attacks: A Diffusion-Weighted MRI Study

Ay¹,

Oliveira‐Filho²,

Buonanno³

et al. 2002

Cerebrovasc Dis

114

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Objective: Diffusion-weighted imaging (DWI) conveys temporal as well as anatomic information about brain infarction, and is therefore well suited to identify ischemic injury that has occurred simultaneously, or closely linked in time, with a transient ischemic attack (TIA). We aimed to determine the proportion and clinical characteristics of patients with TIA who harbor infarction(s) on DWI. Methods: Using T₂-weighted imaging (T₂-WI), fast fluid attenuated inversion recovery (FLAIR), and DWI, we studied 57 consecutive patients presenting with acute focal neurologic symptoms lasting less than 24 h. Results: A hyperintense DWI lesion was identified in a vascular territory appropriate to the symptoms in 27 patients (47%). Lesions judged to be clinically appropriate on T₂-WI and FLAIR overlapped with a DWI lesion in 41 and 48% of patients, respectively. Independent predictors of infarction on DWI were previous nonstereotypic TIAs, presentation with motor symptoms, and identified stroke mechanism. Conclusion: DWI establishes that recent infarction occurs in almost half of patients with the clinical syndrome of TIA and this subgroup is more likely to harbor an underlying cardiac or cerebrovascular abnormality.

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Section: Introductionmentioning

confidence: 99%

‘Footprints’ of Transient Ischemic Attacks: A Diffusion-Weighted MRI Study

Ay¹,

Oliveira‐Filho²,

Buonanno³

et al. 2002

Cerebrovasc Dis

114

View full text Add to dashboard Cite

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“…Upon analysis of this series of case, a significant proportion of the patients described would have been characterized as NESIS according to the proposed clinical score. 40 Another limitation is the fact that some TNS might also have been caused by epileptic seizures that were missed on scalp-EEG or missed because of the lack of prolonged EEG monitoring. Despite this limitation, the proportion of negative EEG, despite most being completed near the seizure event and many patients having multiple EEG, far surpasses what would be expected if all of the events were related to seizures.…”

Section: Discussionmentioning

confidence: 99%

Cortical Spreading Depolarization in Chronic Subdural Hematoma: Bridging the Gap

Lévesque

Deacon

Adam

et al. 2020

Can. J. Neurol. Sci.

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Cortical spreading depolarization (CSD) is recognized as a cause of transient neurological symptoms (TNS) in various clinical entities. Although scientific literature has been flourishing in the field of CSD, it remains an underrecognized pathophysiology in clinical practice. The literature evoking CSD in relation to subdural hematoma (SDH) is particularly scarce. Patients with SDH frequently suffer from TNS, most being attributed to seizures despite an atypical semiology, evolution, and therapeutic response. Recent literature has suggested that a significant proportion of those patients’ TNS represent the clinical manifestations of underlying CSD. Recently, the term Non-Epileptical Stereoytpical Intermittent Symptoms (NESIS) has been proposed to describe a subgroup of patients presenting with TNS in the context of SDH. Indirect evidence and recent research suggest that the pathophysiology of NESIS could represent the clinical manifestation of CSD. This review should provide a concise yet thorough review of the current state of literature behind the pathophysiology of CSD with a particular focus on recent research and knowledge regarding the presence of CSD in the context of subdural hematoma. Although many questions remain in the evolution of knowledge in this field would likely have significant diagnostic, therapeutic, and prognostic implications.

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“…We misdiagnosed this case as a CSDH due to the radiological findings. Although CSDH typically causes subacute to chronic dementia or gait disturbances, some cases can present with transient neurological deficits like TIAs 7 8. The FLAIR MRI sequence findings showed a bright-intensity subdural lesion, while the lesions using a DWI sequence can show variable signals ranging from hypointensity to hyperintensity 9…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid meningitis can present MRI findings that mimic chronic subdural haematoma

Yagita¹,

Shinde

Suenaga

2019

BMJ Case Rep

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A 65-year-old woman with long-standing rheumatoid arthritis (RA) experienced a recurrent tingling sensation in her left arm followed by aphasia and a tingling sensation in her right arm. A subsequent imaging study showed bilateral subdural fluid accumulation and we initially diagnosed her with a transient ischaemic attack and chronic subdural haematoma (CSDH). The cerebral spinal fluid study revealed an inflammatory response without any indications of infection or malignant tumours. After a meningeal biopsy, we redefined the diagnosis to rheumatoid meningitis (RM), and the patient showed remarkable improvement with prednisolone administration. RM should be considered as an alternative diagnosis when examining central nervous system diseases in patients with RA, as RM presents a highly variable clinical picture with image findings similar to those of CSDH.

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Transient neurologic deficit caused by chronic subdural hematoma

Cited by 33 publications

References 8 publications

‘Footprints’ of Transient Ischemic Attacks: A Diffusion-Weighted MRI Study

‘Footprints’ of Transient Ischemic Attacks: A Diffusion-Weighted MRI Study

Cortical Spreading Depolarization in Chronic Subdural Hematoma: Bridging the Gap

Rheumatoid meningitis can present MRI findings that mimic chronic subdural haematoma

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