Presentation
The articles represent the recent advances in hemorrhagic brain injury research presented by highly respected laboratories around the world. [books.google.com]
Our patient's presenting history and imaging findings were characteristic of hematoma, and our patient was managed nonoperatively, and discharged after being observed in the hospital for 48 hours. [ncbi.nlm.nih.gov]
Box 2: Presentations of CSDH Common presentations Altered mental state. Focal neurological deficit. Headache. Falls. Seizures. Transient neurological deficits. Atypical presentations Isolated neurological deficits. Extrapyramidal syndromes. [pmj.bmj.com]
Entire Body System
- Falling
Falls Interestingly falls have been reported to be a very common presenting symptom (74%) in a recent prospective study involving 43 elderly patients. 6 It is a well known fact that recurrent fall is a significant risk factor for CSDH. [pmj.bmj.com]
For example, it might happen from falling out of a chair. [drugs.com]
Overview An intracranial hematoma is a collection of blood within the skull, most commonly caused by rupture of a blood vessel within the brain or from trauma such as a car accident or fall. [mayoclinic.org]
(#1) If a patient falls after admission and is positive for subdural hematoma (HAC), and within several hours declines rapidly and ct shows "massive subdural bleed with midline shift and mass effect with intraventricular hemorrhage and brainstem herniation [forums.acdis.org]
[…] the collection is difficult to see because it is identical in density or 'isodense' to the adjacent brain cortex At 2 months the subdural is 'hypodense' (darker) when compared to the adjacent brain cortex Clinical information Memory loss following a fall [radiologymasterclass.co.uk]
- Asymptomatic
Can be asymptomatic or can gradually increase in size leading to brain herniation. [stritch.luc.edu]
However, small, asymptomatic subchorionic hematomas do not worsen the patient's prognosis. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11] In women whose sonogram shows a subchorionic hematoma, the outcome of the fetus depends on the size of the hematoma, the mother's [emedicine.medscape.com]
This observation raises questions about the pathological significance of MBs and the importance of MB detection in asymptomatic individuals. [alzres.biomedcentral.com]
Residual fluid can be detected on computed tomography in as many as 80% of the patients, a majority of them asymptomatic and clinically insignificant. [pmj.bmj.com]
- Pallor
In more severe cases of chronic or acute bleeding, symptoms may include signs of anemia, such as weakness, pallor, dizziness, shortness of breath or angina. [wakegastro.com]
Eyes
- Retinal Hemorrhage
Their injury history usually was minor or absent. subdural hemorrhage child abuse retinal hemorrhage head injury Received November 20, 2000. Accepted January 15, 2001. [pediatrics.aappublications.org]
Musculoskeletal
- Fracture
A fracture that is displaced by a distance equal to the thickness of the skull or more is a depressed skull fracture. A skull fracture does not necessarily indicate underlying brain damage. [neuropathology-web.org]
[…] low density material The dense (white) material represents recently clotted blood The less dense blood (grey) is not due to a chronic haematoma, it is hyperacute blood which has not yet had time to clot (The bone windows did not demonstrate a skull fracture [radiologymasterclass.co.uk]
Long bone and/or rib fractures were found in 20 (51%) of 39 abused children but in only 1 unintentionally injured child. Retinal bleeding was present in 28 (72%) of 39 of the abused children. [pediatrics.aappublications.org]
Look for fracture skull and soft tissue hematoma as patients may fall down and sustain head injury. Your report should reflect that you evaluated these points. [stritch.luc.edu]
Canadian CT Head Rule: Applies to patients with minor headinjuries with any one of the following: High risk (for neurological intervention): GCS score Suspected open or depressed skull fracture Any sign of basal skull fracture (hemotympanum, “raccoon” [clinicaladvisor.com]
Neurologic
- Vertigo
Sole abnormalities noted were the presence of a persistent low-intensity (6 deg/sec) geotropic positional nystagmus (w/o vertigo). [dizzy.com]
[…] displacement and ischaemia, small repeated haemorrhages in the subdural space, seizure activity with postictal deficits, and spreading cortical depression. 21, 22 ATYPICAL (UNCOMMON) PRESENTATIONS Isolated neurological deficits Patients presenting with vertigo [pmj.bmj.com]
- Nystagmus
Sole abnormalities noted were the presence of a persistent low-intensity (6 deg/sec) geotropic positional nystagmus (w/o vertigo). [dizzy.com]
Nystagmus as the presentation of tentorial incisure subdural haematoma. J Neurol Neurosurg Psychiatry 1994 ; 57 : 830 –1. Phookan G, Cameron M. [pmj.bmj.com]
- Gerstmann Syndrome
Reversible akinetic-rigid syndrome due to bilateral subdural haematomas (letter). Age Ageing 1999 ; 28 : 582 –3. ↵ Maeshima S, Okumura Y, Nakai K, et al. Gerstmann's syndrome associated with chronic subdural haematoma. [pmj.bmj.com]
Workup
CT has traditionally been used in the radiologic workup of ICH (see the image below). However, numerous studies have demonstrated that MRI is more efficient in detecting ICH and in localizing ICH. [emedicine.medscape.com]
Colonoscopy
- Polyps
Colon cancers or colon polyps might also produce lower GI bleeding, as well as different causes for colitis. [wakegastro.com]
Treatment
Treatment of cerebral aneurysms. https://www.uptodate.com/contents/search. Accessed July 5, 2022. Youssef PP, et al. Woven endobridge(WEB) device in the treatment of ruptured aneurysms. [mayoclinic.org]
The health authorities cover all inpatient treatment for patients with intracranial hemorrhage, and costs concerning established treatment options are generally not a concern for the individual patients or their doctors. [f1000research.com]
Burr-hole craniotomy appears to be the most common surgical treatment for evacuation of CSDH. [tncjournal.com]
The topics treated include animal models, pathophysiology of cerebral hemorrhage, experimental treatment for cerebral hemorrhage, cerebral hemorrhage clinical manifestations, prognosis of cerebral hemorrhage, and clinical management. [books.google.com]
Types of interventions Experimental Sclerotherapy of oesophageal varices: any type of sclerotherapy, dosage, and duration of treatment. Control Beta‐blockers: any type of beta‐blocker, dosage, and duration of treatment. [cochranelibrary.com]
Prognosis
Therefore, the prognosis of patients with this type of hematoma is worse than the prognosis of patients with hematoma early in first trimester. [12, 13] The subchorionic hematoma often regresses, especially if it is small or moderate in size. [emedicine.medscape.com]
The topics treated include animal models, pathophysiology of cerebral hemorrhage, experimental treatment for cerebral hemorrhage, cerebral hemorrhage clinical manifestations, prognosis of cerebral hemorrhage, and clinical management. [books.google.com]
[…] injuries Receive prompt medical attention The prognosis for chronic subdural hemorrhage is quite favorable. [drugs.com]
Prognosis The prognosis is variable according to the etiology and macular involvement. [eyewiki.aao.org]
Prognosis varies widely depending on the size and chronicity of the hemorrhage. [radiopaedia.org]
Etiology
Etiology The frequency of the etiologies of vitreous hemorrhage is variable according to the characteristics of the study population. [eyewiki.aao.org]
Definition / general Bleeding between the placental floor and the uterine wall or between the placental parenchyma and membranes May be associated with vaginal bleeding, oligohydramnios and premature delivery Etiology Marginal hemorrhages are related [pathologyoutlines.com]
Objectives • • • • • Types of cerebral strokes and etiology CT and MRI in cerebral hemorrhage CT and MRI in cerebral infarction 4-min Vedio for learning purpose Conclusion 3. [slideshare.net]
Common etiology is head trauma. More common in children as the dura is not as well fixed to the skull as in adults. [stritch.luc.edu]
Etiologic assessment using predetermined criteria was conducted. Results. From March 1995 through December 1998, 66 children were admitted with SDH. [pediatrics.aappublications.org]
Epidemiology
Aneurysmal subarachnoid hemorrhage: Epidemiology, risk factors, and pathogenesis. https://www.uptodate.com/contents/search. Accessed May 6, 2022. Dubosh NM, et al. Diagnosis and initial emergency department management of subarachnoid hemorrhage. [mayoclinic.org]
Methods and design Reporting will be consistent with the strengthening the reporting of observational studies in epidemiology (STROBE) statement. [f1000research.com]
The ‘epidemiologic necropsy’. Unexpected detections, demographic selections, and charging rates of lung cancer JAMA 1987 258 : 331 338 10 Nevo S, Swan V, Enger C et al. [nature.com]
Epidemiology of chronic subdural haematoma. Acta Neurochir 1975;32:247-50. Hamlat A, Mazzon A, Adn M, et al. Intracranial epidural haematomas in elderly patients: observations in 14 patients. Acta Neurochir 2005;147:1055-60; discussion 1060. [acc.org]
Over the last decades, the implementation of these MRI sequences in both epidemiological and clinical studies has revealed MBs as a common finding in many different populations, including healthy individuals. [alzres.biomedcentral.com]
Pathophysiology
The topics treated include animal models, pathophysiology of cerebral hemorrhage, experimental treatment for cerebral hemorrhage, cerebral hemorrhage clinical manifestations, prognosis of cerebral hemorrhage, and clinical management. [books.google.com]
Brain retraction and excessive CSF loss during surgery may be important in the pathophysiological development of RCH. [tncjournal.com]
From a pathophysiological standpoint, MBs appear to be the expression of a hemorrhage-prone state of the brain, which might carry a greater risk of ICH. [alzres.biomedcentral.com]
Jackowski A, Crockard A, Burnstock G, Russell RR, Kristek F (1990) The time course of intracranial pathophysiological changes following experimental subarachnoid haemorrhage in the rat. J Cereb Blood Flow Metab 10:835–849 PubMed Google Scholar 13. [link.springer.com]
This article addresses some of the updated thoughts on pathophysiology of acute SDH. Wilberger, JE, Harris, M, Diamond, DL. "Acute subdural hematoma: Morbidity, mortality, and operative timing". J Neurosurg. vol. 74. 1991. pp. 212-8. [clinicaladvisor.com]
Prevention
If you suffer from abnormalities, such as aneurysms, surgery may help to prevent future bleeding. Be careful with Coumadin. [webmd.com]
Prevention To prevent or minimize head injury: Wear a helmet and make sure your kids wear helmets. [mayoclinic.org]
National Institute of Neurological Disorders and Stroke Preventing stroke (Medical Encyclopedia) Stroke - discharge (Medical Encyclopedia) [ Read More ] [icdlist.com]
Relevance of P-glycoprotein in stroke prevention with dabigatran, rivaroxaban, and apixaban. Herz 2015;40:140-5. Wessler JD, Grip LT, Mendell J, Giugliano RP. The P-glycoprotein transport system and cardiovascular drugs. [acc.org]