Traumatic extradural hematomas with delayed development

Fukamachi, Akira; Misumi, Shuzoh; Kaneko, Masami; Wakao, Tetsuo

doi:10.1016/0730-4862(84)90123-9

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] None of the patients would have been discharged under a strategy for mild head injury requiring a score of GCS 15. (2) 13 studies/126 cases-the complications occurred long after the head injury (mean 34 days, range 2 to 120 days).…”

Section: Resultsmentioning

confidence: 99%

Mild head injury: reliability of early computed tomographic findings in triage for admission

Geijerstam

Britton²

2005

Emergency Medicine Journal

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Objective: To search the literature for case reports on adverse outcomes in patients with mild head injury where acute computed tomography (CT) findings had been normal. Methods: Mild head injury was defined as head trauma involving amnesia or loss of consciousness, but where neurological findings are normal on arrival at hospital (GCS 15). The scientific literature was systematically searched for case reports where an early CT was normal and the patient deteriorated within two days. In these cases, early discharge despite a normal CT head scan would have been hazardous. Results: Two prospective studies were found that investigated the safety of early CT in 3300 patients with mild head injury, as were 39 reports on adverse outcomes describing 821 patients. In addition, 52 studies containing over 62 000 patients with mild head injury were reviewed. In total, only three cases were deemed to have experienced an early adverse outcome despite a normal CT and GCS 15 on initial presentation. In another eight cases with incomplete descriptions, the interpretation was doubtful. Many reports of complications were not relevant to our question and excluded. These reports included cases with more severe head injury/not GCS 15 at presentation, complications that occurred after more than two days, or initial CT findings that were not fully normal. Conclusion: Very few cases were found where an early adverse event occurred after normal acute CT in patients with mild head injury. The strongest scientific evidence available at this time shows that a CT strategy is a safe way to triage patients for admission.

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Section: Resultsmentioning

confidence: 99%

Mild head injury: reliability of early computed tomographic findings in triage for admission

Geijerstam

Britton²

2005

Emergency Medicine Journal

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“…During a 3-year period we treated a total of Abbrevations: CT = computerized tomography; EDH = epidural hematoma; GCS = Glasgow coma score; Interval of delay = interval between initial and second CT scan; Outcome = expressed in Glasgow outcome scores 96 epidural hematomas, eight of which had a delayed onset. DEH comprised about 10 % of traumatic epidural hematomas in several reported series [3,6,8]. The series with the highest reported cases of DEH was by Poon et al [12], in which 22 of 73 cases of epidural hematomas had delayed onset.…”

Section: Discussionmentioning

confidence: 98%

“…Venous bleeding would be enhanced by mechanical ventilation, as elevated intrathoracic pressure results in elevated intracranial venous pressure [3,12]. Loss of a tamponading effect of an evacuated blood collection or the use of mannitol to reduce intracranial pressure can also enhance the appearance of subsequent DEH [3,8,12]. Kaufman et al [11] found that the development of disseminated intravascular clotting and fibrinolysis after head injury predisposed to the formation of DEH in four patients.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Delayed Epidural Hematoma

Radulovic¹,

Janošević²,

Djurovic³

et al. 2006

Zentralbl Neurochir

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“…Delayed traumatic subdural hemorrhages are identified as emerging high-density parenchymal lesions in previously normal or minimally abnormal regions, as described by Gudeman et al [ 9 ] and further elaborated by Fukamachi et al [ 10 ], emphasizing the critical role of imaging in diagnosing delayed SDH. In this case, initial CT scanning conducted immediately post-fall showed no traumatic brain injury.…”

Section: Discussionmentioning

confidence: 99%

Navigating the Challenges of Delayed Subdural Hemorrhage and COVID-19: A Case Report

Al Qahtani,

Alfaraj,

Alzayer

et al. 2024

Cureus

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The delayed onset of posttraumatic subdural hemorrhage (SDH) represents non-specific clinical features, complicating the diagnostic process, especially in individuals predisposed due to pre-existing risk factors and comorbidities. This case report delineates the medical trajectory of a 61-year-old female patient who sustained a traumatic fall, initially displaying neither clinical nor radiological signs indicative of hemorrhage. However, three weeks post-injury, she developed altered mental status, cephalgia, and emesis. Diagnostic imaging unveiled a significant bilateral acute-on-chronic subdural hemorrhage exerting pronounced mass effect and leading to obliteration of the basal cisterns. Complicating her clinical picture was a concurrent SARS-CoV-2 infection and a medical history of hypertension. Emergent neurosurgical intervention was undertaken, encompassing the creation of bilateral burr holes for drainage and the placement of subdural drains. The patient was managed with the requisite medical therapies. Post-operatively, the patient regained consciousness and exhibited significant neurological improvement. Follow-up imaging demonstrated complete resolution of the subdural hemorrhage, and the patient achieved a full recovery of cognitive function. This case underscores the critical necessity for vigilant surveillance for delayed SDH in patients lacking initial radiographic findings and advocates for individualized therapeutic approaches in patients with concurrent pathologies. Prompt recognition, timely neurosurgical management, and care are pivotal to optimizing outcomes in delayed posttraumatic SDH cases.

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Traumatic extradural hematomas with delayed development

Cited by 7 publications

References 10 publications

Mild head injury: reliability of early computed tomographic findings in triage for admission

Mild head injury: reliability of early computed tomographic findings in triage for admission

Traumatic Delayed Epidural Hematoma

Navigating the Challenges of Delayed Subdural Hemorrhage and COVID-19: A Case Report

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