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Kuo Sheng Hung - One of the best experts on this subject based on the ideXlab platform.
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traumatic spinal Subdural Hematoma with spontaneous resolution
Spine, 2002Co-Authors: Kuo Sheng Hung, Chun Chung Lui, Cheng Haung Wang, Ching Jen Wang, Shen Long HowngAbstract:Study Design. A case report with a literature review is presented. Objective. To describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of traumatic spinal Subdural Hematoma. Summary of Background Data. Traumatic spinal Subdural Hematoma is uncommon, and only eight cases have been reported in the literature. Concomitant intracranial and spinal Subdural Hematoma in the same patient has not been well studied. Methods. A case of concomitant spinal and intracranial Subdural Hematoma is reported as well as a review of the literature. Results. Including our patient, we found that five of the nine patients with traumatic spinal Subdural Hematoma also had intracranial Hematoma. We hypothesize that the mechanism of traumatic spinal Subdural Hematoma may be associated with intracranial events. Recognition of blood products in magnetic resonance imaging scans is important to distinguish spinal Subdural Hematoma from other spinal lesions. It is generally agreed that prompt laminectomy with evacuation of Hematoma should be performed before irreversible damage to the spinal cord occurs. However, including our patient, three of the nine reported cases with thoracic or lumbar Subdural Hematoma resolved spontaneously with conservative treatment. Conclusions. This 12-year-old boy illustrated the rapid spontaneous resolution of traumatic Subdural Hematoma in both left hemisphere and lumbar spine with conservative treatment. This report suggests a possible role of conservative management for traumatic lumbar Subdural Hematoma, especially when the patients already have neurologic recovery.
Shen Long Howng - One of the best experts on this subject based on the ideXlab platform.
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traumatic spinal Subdural Hematoma with spontaneous resolution
Spine, 2002Co-Authors: Kuo Sheng Hung, Chun Chung Lui, Cheng Haung Wang, Ching Jen Wang, Shen Long HowngAbstract:Study Design. A case report with a literature review is presented. Objective. To describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of traumatic spinal Subdural Hematoma. Summary of Background Data. Traumatic spinal Subdural Hematoma is uncommon, and only eight cases have been reported in the literature. Concomitant intracranial and spinal Subdural Hematoma in the same patient has not been well studied. Methods. A case of concomitant spinal and intracranial Subdural Hematoma is reported as well as a review of the literature. Results. Including our patient, we found that five of the nine patients with traumatic spinal Subdural Hematoma also had intracranial Hematoma. We hypothesize that the mechanism of traumatic spinal Subdural Hematoma may be associated with intracranial events. Recognition of blood products in magnetic resonance imaging scans is important to distinguish spinal Subdural Hematoma from other spinal lesions. It is generally agreed that prompt laminectomy with evacuation of Hematoma should be performed before irreversible damage to the spinal cord occurs. However, including our patient, three of the nine reported cases with thoracic or lumbar Subdural Hematoma resolved spontaneously with conservative treatment. Conclusions. This 12-year-old boy illustrated the rapid spontaneous resolution of traumatic Subdural Hematoma in both left hemisphere and lumbar spine with conservative treatment. This report suggests a possible role of conservative management for traumatic lumbar Subdural Hematoma, especially when the patients already have neurologic recovery.
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Acute Subdural Hematoma in infancy
Surgical Neurology, 2002Co-Authors: Joon-khim Loh, Chih-lung Lin, Aij-lie Kwan, Shen Long HowngAbstract:BACKGROUND Acute Subdural Hematoma in infants is distinct from that occurring in older children or adults because of differences in mechanism, injury thresholds, and the frequency with which the question of nonaccidental injury is encountered. The purpose of this study is to analyze the clinical characteristics of acute Subdural Hematoma in infancy, to discover the common patterns of this trauma, and to outline the management principles within this group. METHODS Medical records and films of 21 cases of infantile acute Subdural Hematoma were reviewed retrospectively. Diagnosis was made by computed tomography or magnetic resonance imaging. Medical records were reviewed for comparison of age, gender, cause of injury, clinical presentation, surgical management, and outcome. RESULTS Twenty-one infants (9 girls and 12 boys) were identified with acute Subdural Hematoma, with ages ranging from 6 days to 12 months. The most common cause of injury was shaken baby syndrome. The most common clinical presentations were seizure, retinal hemorrhage, and consciousness disturbance. Eight patients with large Subdural Hematomas underwent craniotomy and evacuation of the blood clot. None of these patients developed chronic Subdural Hematoma. Thirteen patients with smaller Subdural Hematomas were treated conservatively. Among these patients, 11 developed chronic Subdural Hematomas 15 to 80 days (mean = 28 days) after the acute Subdural Hematomas. All patients with chronic Subdural Hematomas underwent burr hole and external drainage of the Subdural Hematoma. At follow-up, 13 (62%) had good recovery, 4 (19%) had moderate disability, 3 (14%) had severe disability, and 1 (5%) died. Based on GCS on admission, one (5%) had mild (GCS 13-15), 12 (57%) had moderate (GCS 9-12), and 8 (38%) had severe (GCS 8 or under) head injury. Good recovery was found in 100% (1/1), 75% (8/12), and 50% (4/8) of the patients with mild, moderate, and severe head injury, respectively. Sixty-three percent (5/8) of those patients undergoing operation for acute Subdural Hematomas and 62% (8/13) of those patients treated conservatively had good outcomes. CONCLUSIONS Infantile acute Subdural Hematoma if treated conservatively or neglected, is an important cause of infantile chronic Subdural Hematoma. Early recognition and suitable treatment may improve the outcome of this injury. If treatment is delayed or the condition is undiagnosed, acute Subdural Hematoma may cause severe morbidity or even fatality.
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Acute Subdural Hematoma in infancy.
Surgical Neurology, 2002Co-Authors: Joon-khim Loh, Chih-lung Lin, Aij-lie Kwan, Shen Long HowngAbstract:Acute Subdural Hematoma in infants is distinct from that occurring in older children or adults because of differences in mechanism, injury thresholds, and the frequency with which the question of nonaccidental injury is encountered. The purpose of this study is to analyze the clinical characteristics of acute Subdural Hematoma in infancy, to discover the common patterns of this trauma, and to outline the management principles within this group. Medical records and films of 21 cases of infantile acute Subdural Hematoma were reviewed retrospectively. Diagnosis was made by computed tomography or magnetic resonance imaging. Medical records were reviewed for comparison of age, gender, cause of injury, clinical presentation, surgical management, and outcome. Twenty-one infants (9 girls and 12 boys) were identified with acute Subdural Hematoma, with ages ranging from 6 days to 12 months. The most common cause of injury was shaken baby syndrome. The most common clinical presentations were seizure, retinal hemorrhage, and consciousness disturbance. Eight patients with large Subdural Hematomas underwent craniotomy and evacuation of the blood clot. None of these patients developed chronic Subdural Hematoma. Thirteen patients with smaller Subdural Hematomas were treated conservatively. Among these patients, 11 developed chronic Subdural Hematomas 15 to 80 days (mean = 28 days) after the acute Subdural Hematomas. All patients with chronic Subdural Hematomas underwent burr hole and external drainage of the Subdural Hematoma. At follow-up, 13 (62%) had good recovery, 4 (19%) had moderate disability, 3 (14%) had severe disability, and 1 (5%) died. Based on GCS on admission, one (5%) had mild (GCS 13-15), 12 (57%) had moderate (GCS 9-12), and 8 (38%) had severe (GCS 8 or under) head injury. Good recovery was found in 100% (1/1), 75% (8/12), and 50% (4/8) of the patients with mild, moderate, and severe head injury, respectively. Sixty-three percent (5/8) of those patients undergoing operation for acute Subdural Hematomas and 62% (8/13) of those patients treated conservatively had good outcomes. Infantile acute Subdural Hematoma if treated conservatively or neglected, is an important cause of infantile chronic Subdural Hematoma. Early recognition and suitable treatment may improve the outcome of this injury. If treatment is delayed or the condition is undiagnosed, acute Subdural Hematoma may cause severe morbidity or even fatality.
Wagih El S Masry - One of the best experts on this subject based on the ideXlab platform.
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acute spontaneous spinal Subdural Hematoma presenting as paraplegia a rare case
Spine, 2007Co-Authors: Athanasios E Kyriakides, Radesh K Lalam, Wagih El S MasryAbstract:Study Design. Case report. Objectives. To report an unusual case of spontaneous spinal Subdural Hematoma and to review relevant literature and discuss the etiology, pathogenesis, clinical features, imaging, and prognosis. Summary of Background Data. Spontaneous spinal Subdural Hematoma with no underline pathology is a very rare condition. Only 19 cases have been previously reported. Methods. The case of a 44-year-old man is presented. Pubmed (Medline) was used to search publications. Results. Our patient presented with sudden severe low back pain following a minimal effort, with rapid onset of complete paraplegia. MRI revealed an anterior Subdural Hematoma from T2–T6 with cord compression. An urgent laminectomy was performed. MRI scan, surgery, and CT angiogram did not reveal any underlying pathology to account for the Subdural Hematoma. The patient demonstrated substantial clinical improvement after 6 weeks of bed rest and intense rehabilitation program. Conclusion. Spinal Subdural Hematoma (SSDH) is uncommon and can be caused by abnormalities of coagulation, blood dyscrasias, or trauma, underlying neoplasm, and arteriovenous malformation. SSDH is very rare in the absence of these underlying conditions. It occurs most commonly in the thoracic spine and presents with sudden back pain radiating to the arms, legs or trunk, varying degrees of motor, sensory, and autonomic disturbances. On MRI, SSDH is seen as a space-occupying lesion, usually ventrally, contained within the dura matter, and can demonstrate variable T1 and T2 signal depending on the age of the Hematoma. The prognosis is variable. The majority of cases in the literature had surgical decompression, although cases that were managed conservatively have been reported to be successful as well. The indications of surgery need to be clarified.
Chun Chung Lui - One of the best experts on this subject based on the ideXlab platform.
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traumatic spinal Subdural Hematoma with spontaneous resolution
Spine, 2002Co-Authors: Kuo Sheng Hung, Chun Chung Lui, Cheng Haung Wang, Ching Jen Wang, Shen Long HowngAbstract:Study Design. A case report with a literature review is presented. Objective. To describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of traumatic spinal Subdural Hematoma. Summary of Background Data. Traumatic spinal Subdural Hematoma is uncommon, and only eight cases have been reported in the literature. Concomitant intracranial and spinal Subdural Hematoma in the same patient has not been well studied. Methods. A case of concomitant spinal and intracranial Subdural Hematoma is reported as well as a review of the literature. Results. Including our patient, we found that five of the nine patients with traumatic spinal Subdural Hematoma also had intracranial Hematoma. We hypothesize that the mechanism of traumatic spinal Subdural Hematoma may be associated with intracranial events. Recognition of blood products in magnetic resonance imaging scans is important to distinguish spinal Subdural Hematoma from other spinal lesions. It is generally agreed that prompt laminectomy with evacuation of Hematoma should be performed before irreversible damage to the spinal cord occurs. However, including our patient, three of the nine reported cases with thoracic or lumbar Subdural Hematoma resolved spontaneously with conservative treatment. Conclusions. This 12-year-old boy illustrated the rapid spontaneous resolution of traumatic Subdural Hematoma in both left hemisphere and lumbar spine with conservative treatment. This report suggests a possible role of conservative management for traumatic lumbar Subdural Hematoma, especially when the patients already have neurologic recovery.
Ching Jen Wang - One of the best experts on this subject based on the ideXlab platform.
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traumatic spinal Subdural Hematoma with spontaneous resolution
Spine, 2002Co-Authors: Kuo Sheng Hung, Chun Chung Lui, Cheng Haung Wang, Ching Jen Wang, Shen Long HowngAbstract:Study Design. A case report with a literature review is presented. Objective. To describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of traumatic spinal Subdural Hematoma. Summary of Background Data. Traumatic spinal Subdural Hematoma is uncommon, and only eight cases have been reported in the literature. Concomitant intracranial and spinal Subdural Hematoma in the same patient has not been well studied. Methods. A case of concomitant spinal and intracranial Subdural Hematoma is reported as well as a review of the literature. Results. Including our patient, we found that five of the nine patients with traumatic spinal Subdural Hematoma also had intracranial Hematoma. We hypothesize that the mechanism of traumatic spinal Subdural Hematoma may be associated with intracranial events. Recognition of blood products in magnetic resonance imaging scans is important to distinguish spinal Subdural Hematoma from other spinal lesions. It is generally agreed that prompt laminectomy with evacuation of Hematoma should be performed before irreversible damage to the spinal cord occurs. However, including our patient, three of the nine reported cases with thoracic or lumbar Subdural Hematoma resolved spontaneously with conservative treatment. Conclusions. This 12-year-old boy illustrated the rapid spontaneous resolution of traumatic Subdural Hematoma in both left hemisphere and lumbar spine with conservative treatment. This report suggests a possible role of conservative management for traumatic lumbar Subdural Hematoma, especially when the patients already have neurologic recovery.
