Membrane stain in chronic subdural hematoma: A rare angiographic sign

Summary Chronic subdural hematoma is diagnosed angiographically by the presence of an avascular zone as a result of medial displacement of the cerebral surface vessels from the inner table. A rare angiographic sign, membrane stain, is reported in a case of chronic subdural hematoma. The stain is presumed to represent the vascular membrane of the chronic subdural hematoma.     

Is acute subdural hematoma reduced during the agonal stage and postmortem?

The issue of proper use of postmortem computed tomography (PMCT) in forensic fields is currently being actively discussed. The PMCT image has specific findings that differ from the antemortem image, and it is essential to understand and interpret postmortem changes in order to utilize PMCT properly. In this article, we present two cases of acute subdural hematoma (ASDH) in which images were obtained both ante- and postmortem. These images showed marked reduction of hematoma and diminishing midline shift between the agonal and postmortem periods, without evacuation of the hematoma. Attention should be paid to this phenomenon because key findings in determining cause of death could disappear if investigating the cause of death takes too long in cases that prove to be ASDH. In other words, this phenomenon potentially becomes a risk for misdiagnosis when we decide the cause of death without knowing the details of the circumstances of death.     

Delayed epidural hematoma after evacuation of a subdural hematoma

CT easily diagnoses epidural hematomas. The appearance of an epidural hematoma may be delayed by compression from a contralateral lesion. The possibility of a delayed epidural hematoma should be kept in mind in the presence of additional findings such as a skull fracture contralateral to the original lesion or decompression of the epidural hematoma into either the subgaleal or the subarachnoid space. We present a case in which an epidural hematoma declared itself after the evacuation of a contralateral subdural hematoma.     

Spinal subdural hematoma

 We report the case of a 68-year-old patient with a traumatic spinal subdural hematoma. MRI demonstrated an area of abnormal intensity and a black line in the inner part of the intradural space. We anti-cipate that MRI will help to make one more confident in the preoper-ative diagnosis of spinal subdural hematoma. The symptoms complet-ely disappeared immediately after the operation. Spinal subdural he-matoma requires immediate surgical evacuation. The prognosis for func-tional recovery is good if the condi-tion is appropriately diagnosed and treated before development of irre-versible paralysis. We recom-mend MRI to make an early diagnos-is and early evacuation of spinal subdural hematoma.     

CT findings in a case of neonatal acute subdural hematoma

Summary The CT findings in a case of neonatal acute subdural hematoma are presented. CT demonstrated a crescentic high density area in the subdural space over the left cerebral hemisphere and an oval high density area in the left occipital region. The latter was suspected of being an intracerebral hematoma. Emergency craniotomy revealed that the high density area was due to a subdural hematoma between the occipital lobe and the tentorium cerebelli.     

Acute infratentorial traumatic subdural hematoma associated with a torn tentorium cerebelli in a one-year-old boy

Summary The case of a 1-year-old boy with an acute infratentorial subdural hematoma is presented. Surgical intervention revealed a bleeding vein at the edge of a right-sided tentorial tear. Traumatic tentorial tearing has been demonstrated previously only in neonates. Although computed tomography is the most effective method for recognition of this lesion, vertebral angiography may be mandatory for more accurate localization.     

MRI depiction of chronic intradural (subdural) hematoma in evolution

The usual chronic subdural hematoma encountered in the elderly is actually thought to be a chronic intradural hematoma, which has been described clinically and anatomically. However, the evolution of how this chronic hematoma occurs remains enigmatic. We report the first magnetic resonance (MR) depiction of an apparent chronic intradural hematoma in evolution over several months in a 61-year-old man after a minimal head injury. The time delay from injury, subsequent focal pachymeningeal T1-gadolinium enhancement, and apparent splitting of the pachymeninges by proven chronic hematoma should serve as a stimulus for further MR investigations of this interesting process.     

Meningioma presenting as an acute subdural hematoma

Most subdural hematomas occur as a sequel of trauma. Non-traumatic subdural hematomas may be found in patients with ruptured aneurysm, arteriovenous malformation, dural arteriovenous fistula, amyloid angiopathy, renal insufficiency, and cocaine abuse. Hypervascular primary and metastatic tumors may also present with subdural hematomas. We present the MR imaging features in a patient who presented with an acute subdural hematoma presumably caused by an underlying meningioma.     

Detection of AB0 blood group-active glycolipids extracted from red cell membrane and heat hematoma using TLC-immunostaining

Summary Glycolipids extracted from groups A, B, and 0 erythrocytes were developed on thin-layer plates; their AB0 blood group antigenicities were detected by immunostaining method using avidin-biotin-complex (ABC). Among series of glycolipids of different flow rates, antigen-specific staining was observed in five bands from group A₁ erythrocytes, four bands from group B, and two bands from group O. Monoclonal anti-A, -B, and -H antibodies specifically stained glycolipids from A₁, B, and 0 erythrocytes, respectively.AB0 blood grouping was possible from 5 g of epidural heat hematoma of a charred body by this method. ABC immunostaining on thin-layer chromatography is a useful and reliable method for AB0 blood grouping in forensic practice.Supported in part by a scientific grant from the Ministry of Education, Science, and Culture, Japan     

双侧慢性硬膜下血肿的CT诊断(附43例分析)

目的：本文报告43例双侧慢性硬膜下血肿的CT诊断。方法：回顾分析43例双侧慢性硬膜下血肿的CT检查资料。结果：43例共86个血肿，血肿呈混杂密度42个，等密度32个，低密度12个；血肿呈新月形66个、半月形15个、3字形5个；伴脑灰白质界面内移43例，侧脑室变窄41例，中线结构移位17例。结论：双侧慢性硬膜下血肿多见于老年男性患者，CT检查是诊断本病最简单而可靠的方法。     

A rare combination of complications of ruptured carotid artery aneurysm: A case report.

The giant aneurysm of the subclinoid portion of the internal carotid artery is a relatively rare disease that can present serious complications. We present the case of a 40-year-old guy who was suffering from a headache and had complete ophthalmoplegia in his right eye. A brain scan shows a right temporal subdural hematoma, associated with subarachnoid hemorrhage, and total Sylvian subacute ischemic stroke. CT angiography and MRI showed a ruptured and partially thrombosed aneurysm of the subclinoid portion of the right internal carotid artery complicated by subarachnoid hemorrhage, a right subdural temporal hematoma, and total Sylvian ischemic stroke. Our purpose is to recognize the possibility of an aneurysmal rupture when evaluating an acute subdural hematoma, alone or in combination with Ischemic stroke.     

慢性硬膜下血肿患者33例手术后认知功能改善分析

目的：探讨慢性硬膜下血肿（chronic subdural hematoma）对轻度认知功能损害的相关关系。方法：对33例通过CT扫描确诊的慢性硬膜下血肿患者,术前进行认知功能评价。并于手术后1周再次进行认知功能评估,通过对术前术后认知功能的评估结果,分析慢性硬膜下血肿是否导致患者认知功能障碍,并初步判断手术是否早期可以改善患者认知功能障碍。结果：33例患者中,有32例出现认知功能障碍,但都表现为轻度认知功能障碍,手术后,患者认知功能障碍有好转（MMSE评分有统计学意义）。结论：慢性硬膜下血肿可以伴随认知功能改变,手术治疗后,可以改善患者认知功能障碍。     

Non-traumatic bilateral rectus sheath hematoma during septic disseminated intravascular coagulation

A non-traumatic abdominal wall hematoma is rare, and occurs occasionally due to coughing, physical activity, or antithrombotic/anticoagulant therapy. The condition is usually unilateral; however, rare bilateral cases have been reported. Here, we report a rare case of a non-traumatic bilateral rectus sheath hematoma. The patient was a 60-year-old woman who was urgently admitted to our hospital due to the occurrence of pneumonia during postoperative chemotherapy for breast cancer. Because she exhibited disseminated intravascular coagulation, a therapy with antibacterial agents, thrombomodulin alpha, and catecholamines was initiated. During hospitalization, hemorrhagic shock due to hematomas in both rectus abdominis muscles was observed without any discernible cause. Subsequent emergency angioembolization was successful, and abdominal computed tomography performed 3 months after the onset of the rectus sheath hematoma confirmed a reduction in the hematoma size.     

Chronic subdural hematoma: correlation of computerized tomography with colour

Summary The computerized tomographic and operative findings in 10 patients with chronic subdural hematoma (SDH) are reviewed. A constant correlation was found between the CT density and the colour of the hematoma evacuated thus enabling an accurate prediction of the colour of fluid one would expect to find at operation. Certain clinical features and CT appearances are highlighted to prevent the likelihood of misdiagnoses.     

Acute massive subdural hematoma caused by rupture of internal carotid artery aneurysm during angiography: a case report

We present a case of acute, massive subdural hemorrhage caused by rupture of an internal carotid artery aneurysm during the procedure of cerebral angiography. To our knowledge, a case like the present one has been reported only once in the English-language literature. The incidence, mechanisms, treatment, and prognosis of (1) subdural hematoma, caused by rupture of cerebral aneurysm, and (2) re-rupture of aneurysm during the angiography procedure are discussed. Electronic Publication     

微创软通道对慢性硬膜下血肿的治疗

目的探讨慢性硬膜下血肿的简便、安全、有效的临床治疗方法。方法选择慢性硬膜下血肿的病人,随机分为传统外科手术组(对照组)和微创治疗组,对照组采用传统的外科手术治疗,微创治疗组采用简易脑立体定向微创软通道技术。结果两组治疗效果、复发率异差无统计学意义(P>0.05),两组的平均住院时间比较差异有统计学意义(P<0.05),外科手术治疗组平均住院时间高于微创治疗组。结论慢性硬膜下血肿实施定向微创软通道手术,较对照组,可减轻患者手术痛苦、扩大手术实施的人群范围,减少患者平均住院天数,治疗效果与传统外科手术治疗,无显著差异。     

大脑镰硬膜下血肿的CT诊断

目的评价CT对大脑镰硬膜下血肿诊断的可行性。方法回顾性分析25例具有完整资料的外伤性大脑镰硬膜下血肿的CT表现。结果25例中,14例表现细绳索状高密度影,11例表现粗绳索状高密度影;粗绳索状影近中线侧平直,外侧呈浅波浪状,其对应脑回受压远离中线,脑沟及纵裂池模糊或消失。结论大脑镰硬膜下血肿是硬膜下血肿的一种少见类型,通过分析CT征象,能够作出正确诊断。     

快速自溶的急性硬膜下血肿的CT特征与吸收机理

目的 :总结快速自溶的急性硬膜下血肿 (acutesubduralhematoma ,ASDH)的CT特征 ,并对其溶解吸收机理及与CT表现的相互关系进行探讨。方法 :收集 15例急性期内完全或大部分溶解吸收的ASDH病例 ,男 8例 ,女 7例 ,均为外伤所致。全部用TOSHIBAXvision 32 0 0常规扫描 ,层厚层距均为 10mm ,对血肿层厚小于两个层面的采用 3mm薄层扫描。结果 :15个ASDH于急性期或亚急性期完全溶解吸收 ,出血量均 <15ml,12个与颅内板局部或全部有低密度间隙。结论 :ASDH的快速自溶吸收与脑脊液 (CSF)的灌注对血肿的稀释和回流吸收 ,以及肿胀实质对硬膜下腔的挤压有关     

A hematoma of the esophagus causing the trachea to stenose

We report a case of spontaneous intramural hematoma of the esophagus (SIHE) with severe dyspnea due to compression of the trachea. SIHE is a rare hematoma that commonly presents with chest pain, epigastralgia, hematemesis, and dysphagia. Dyspnea is not a common symptom; it has been reported in only one patient, who underwent surgery. In our case, intubation of the compressed trachea prevented it from becoming more stenosed, and an operation was not needed. Another unusual feature of this case is the endoscopic findings. Endoscopic examination in SIHE has often revealed the presence of a dark red, bluish, or purplish bulge, suggesting the presence of a clot or blood in the esophageal wall. In our case, the bulge revealed by endoscopy in the esophageal lumen was white at first, before later turning dark red. Electronic Publication     

Cervical and mediastinal hematoma: presentation of an asymptomatic cervical parathyroid adenoma: case report and literature review

The spontaneous rupture with extracapsular hemorrhage of a cervical parathyroid adenoma is a rare cause of cervical and mediastinal hematoma. We describe this case to emphasize that a failure to consider this diagnosis may result in delayed operative intervention with potentially fatal complications.