To assess the different treatment modalities of sdhy regarding the patients characteristics and clinical. However, they should be considered in patients after spinal anesthesia with continuing orthostatic headache, especially if contributing factors are present, such as a ventriculoperitoneal shunt or brain atrophy caused by old age or alcoholism. If the inline pdf is not rendering correctly, you can download the pdf file here. Subdural hygroma published on jul 1945 by journal of neurosurgery publishing group.
Roentgendiagnosis of subdural hygroma in infants pdf. They are commonly seen in elderly people after minor trauma but can also be seen in children after an infection. Aug 28, 2019 subdural higroma is an accumulation of csf in the subdural higrkmas in an acute or chronic process, which is generally secondary to trauma. A guide for patients and families 4 chronic subdural hematomas are sometimes hard to diagnose because their symptoms can resemble so many different conditions. An acute subdural hygroma results from the acute accumulation of csf within the dural border cell layer. Jun, 2019 ultrasound findings, such as ch and hydrops, may assist in its detection 1. Higromxs has been proposed that subdural hygromas, at least sometimes, represent prominent subdural effusions in which there is a separation of the dural border cell layer with an accumulation of fluid 7. Conservative treatment in the management of traumatic. Subdural hygromas refer to the accumulation of fluid in the subdural space. Aug 29, 2019 the vast majority of patients with subdural hygroma are asymptomatic without radiographic evidence of masseffect, and thus neurosurgical intervention is rarely required 5. The presence of traumatic subdural hygroma is assumed when lucent fluid is seen in the subdural space too soon after trauma within four or five days, at least to be explained on the basis of protein absorption from a preexisting hematoma.
Collections of lowprotein fluid, called subdural hygromas, may develop after placement of a shunt with low pressure. Epidemiology subdural hygromas are encountered in all a a subdural hygroma is a collection of cerebrospinal fluid csf vos, without blood, located under the dural membrane. Question are changes in subdural hematoma incidence related to antithrombotic drug use findings in this observational study with 10 010 subdural hematoma cases and 400 380 controls, subdural hematoma risk was significantly associated with antithrombotic drug use, in particular use of a vitamin k antagonist adjusted odds ratio, 3. The purpose of this retrospective study was to verify our conclusion drawn from the model, namely, that the cortical vein sign is specific for atrophy and excludes a diagnosis of subdural hygroma. Subdural hematoma is the result of bleeding over the surface of the brain, beneath the dura. Postpartum subdural hygroma after epidural analgesia. Inadvertent dural puncture during epidural anesthesia leads to intracranial hypotension, which if left unnoticed can cause lifethreatening subdural hematomas or cerebellar tonsillar herniation. In this report, the authors present a diagnostic method for differentiating external hydrocephalus from simple subdural hygroma, based on their clinical experience in treating. Subdural hygroma and chronic subdural hematoma can be readily differentiated on the ct scan.
It appeared that these patients did not have any distinguishing clinical features early on. Of course, the presence of a subdural hygroma and an sdh is not mutually exclusive. It is not obvious why a membrane would develop under these circumstances, although fluid of the nature described could be accounted for either by bleeding or secretion. Differentiating external hydrocephalus from simple subdural hygroma may be difficult, but the former appears to be a distinct clinical entity separate from the latter. Apr 24, 2020 higromas frontales pdf higroma subdural traumatico. When a subdural hygroma is seen in infants and children it is often after they have had an infection but it could also be from a minor head injury from falling, hitting their head, or even child abuse. Subdural hematoma and hygroma are rare complications of spinal anesthesia. After showing initial improvement, 10 weeks after the initial surgery the patient progressively worsened and became unresponsive. The clot was evacuated and the bone flap was left out. Spontaneous evolution of posttraumatic subdural hygroma into. Abstract as the accumulation of cerebrospinal fluid csf after. Different treatment modalities and clinical outcome article pdf available in open journal of modern neurosurgery 0903. Subdural hygroma sd hy is mostly asympto matic and has a regr essive course, but sometimes, it may cause mas s effect and become a life threatening condition requiring surgical intervention 8.
Association of antithrombotic drug use with subdural hematoma. Csf contains prealbumin not present in subdural hematoma and may be under high pressure. In subdural hematoma, the position of the veins may be similar to that in subdural hygroma or may be ruptured as shown. Subdural hematoma sdh a guide for patients and families. The fate of traumatic subdural hygroma in serial computed tomographic scans. Spontaneous resolution of subdural collection along with cerebral expansion. Bleeding stops higromsa the sdh accumulates and tamponades the site of venous bleeding. Enhanced density and heterogeneous appearance 53rd day signs of subdural bleeding into hygroma space. Subdural hygroma definition, symptoms, causes, treatment.
The demographics will depend on the underlying cause which includes. What symptoms a person has with a general hygroma depends on the cause. One of the common causes of subdural hygroma is a sudden decrease in pressure as a. Epidemiology subdural hygromas are encountered in all a. It is usually asymptomatic but may alter consciousness. In this study, we investigated the clinical characteristics of subdural hygroma in patients with traumatic brain injury. We present the case of a young laboring adult female, who developed subdural hygromas and a subdural. The highly variable presentation of intracranial hypotension hinders timely diagnosis and treatment. On ct imaging, an acute subdural hygroma exists when a csf isodense or nearly isodense subdural collection accumulates acutely fig. Most subdural hygromas are believed to be derived from chronic subdural hematomas. A ct scan 2 weeks later showed almost complete resolution of the hygroma figure 2c and improvement in neurological status.
Surgical treatment of subdural hygromas in infants and children. Descriptions in literature of evolving trau matic subdural hygroma have presented ct scan density modifications changing into chronic subdural hematoma. Management of subdural hygromas associated with arachnoid cysts. Jul 12, 2017 a subdural hematoma occurs when a vein ruptures between your skull and your brains surface. In our series of 49 cases techically satisfactory eneephalograms were obtained in 45 cases. A hygroma must not be excluded until films have been taken in this pro jection. Management is still a matter of controversy conservative vssurgical especially when consciousness is a concern.
These had been regarded as evidence of an emotional. A computed tomographic ct scan showed a large rightsided subdural hygroma and right temporal lobe edema. The comparison between surgical procedure and conservative. The disease course was marked by a transformation of the sdh into subdural hematoma in one of the two patients. Traumatic subdural hygroma neurosurgery oxford academic. Subdural hygroma may also develop in infants after infection where it may be misdiagnosed as subdural empyema 6. Csdhs were found at the site of sdhys with no history of further head injury at a mean interval of 56 days. Permission is granted to copy, distribute andor modify this document under the terms of the gnu free documentation license, version 1.
Other causes of subdural hygroma include, spontaneous subdural hygroma that may occur due to rupture of arachnoid cyst, and postoperative that develops after decompressive craniectomy, cranioplasty or shunt installation 4 8. Subdural hygroma associated with photogenic epilepsy. Up to 40 percent of sdhs among the elderly were misdiagnosed at the time of hospital admission, often as dementia. In many cases, it is considered an epiphenomenon of head injury when it is called a traumatic subdural hygroma. Higromas frontales pdf higroma subdural traumatico. The pathogenesis and clinical significance of traumatic subdural hygroma. This can result from an acute tear in both the arachnoid and the dural border cell layer, resulting in communication of these two spaces. Report of a case a yearold boy had suffered from early childhood from brief lapses of attention. Traumatic subdural hygroma neurosurgery oxford academic dois.
Epidural anesthesia complicated by subdural hygromas and a. Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to other cause before regaining consciousness, initial encounter. Subdural hygroma sdhy is a collection of cerebrospinal fluid csf under the dural membrane. Subdural hygromas can be found incidentally on imaging for other reasons or seen accumulating relatively quickly following a closed head injury. Mr characteristics of subdural hematomas and hygromas at 1. In two cases of the present study, the lesions were hypointense on t1weighted sequences, and hyperintense on t2weighted sequences, with thin septations inside. Symptomatic subdural hygroma and temporal lobe edema after. Subdural hygroma in head trauma patients admitted to a hospital.
A subdural hygroma radiographically appears as a crescentic nearcsf densitysignal accumulation in the subdural space that does not extend into the sulci and rarely exerts significant masseffect 5. Subdural hygroma shy is an accumulation of a csflike fluid in the subdural space. Simple evacuation of the hygroma and cranioplasty was done. The formation of cranial subdural hematomas after lumbar puncture is a wellknown complication of spinal anesthesia, although rare in young patients. Ct scans showed a large subdural hygroma on the right with midline shift to the left.
Thirteen of 145 patients with posttraumatic subdural hygroma sdhy developed chronic subdural haematoma csdh at the involved site over a period of 6 years. Subdural hygroma definition of subdural hygroma by medical. The wound was then opened, the hygroma fluid was drained out, and cranioplasty was performed. Since a subdural hygroma is characteristically localiz ed in the frontolateral region of the skull, we routinely take tangential films over this area. The patient underwent burr hole evacuation of the collection and placement of a subdural drain, after which the edema in the temporal lobe and hygroma resolved. Subdural hygroma definition of subdural hygroma by.
Subdural hygromas generally occur along the supratentorial cerebral convexities. Epidemiological features of patients with subdural hygroma in a. Diagnostic method for differentiating external hydrocephalus. If you sustain a major brain injury, this area can fill with blood and. A subdural hygroma is the accumulation of clear or xanthochromic csf within the subdural space. Drainage and cranioplasty as a treatment for traumatic. Request pdf normal pressure subdural hygroma with mass effect as a complication of decompressive craniectomy subdural posttraumatic collections are called usually traumatic subdural hygroma tsh.
317 666 69 1093 1315 1260 780 288 916 74 145 1140 267 1435 1322 994 34 1318 1402 716 1162 689 1012 1230 1021 925 131 589 287 322 570