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Epidural hematoma

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https://www.readbyqxmd.com/read/28444463/cost-effectiveness-of-craniotomy-for-epidural-hematomas-at-a-major-government-hospital-in-cambodia
#1
Dane Moran, Mark G Shrime, Sam Nang, Iv Vycheth, Din Vuthy, Raksmey Hong, William V Padula, Kee B Park
BACKGROUND: Epidural hematoma (EDH) is a common and potentially deadly occurrence following a severe traumatic brain injury. Our aim was to determine whether craniotomy is cost-effective when indicated for the treatment of EDH when a trained neurosurgeon is available. METHODS: A decision tree was used to model the cost-effectiveness of craniotomy available versus craniotomy unavailable for the management of traumatic EDH from a Cambodian societal and provider perspective...
April 25, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28435919/spontaneous-spinal-epidural-hematoma-literature-review
#2
REVIEW
Jessica Figueroa, John G DeVine
Review the current literature regarding spontaneous spinal epidural hematomas (SSEHs) and report on the known risk factors, evaluation, and treatment of this rare entity. A literature search was performed using PubMed and Ovid to identify articles pertaining to SSEHs. Due to the rarity of the pathologic entity, only scattered case reports and associated reviews are available. SSEHs are a rare yet potentially life-altering event. The underlying risk factors are poorly understood, and SSEHs present with minimal or no antecedent trauma...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28427979/a-new-type-of-spinal-epidural-arteriovenous-fistulas-causes-spinal-epidural-hemorrhage-an-analysis-of-five-cases-and-natural-history-consideration
#3
Jia-Xing Yu, Tao Hong, Yong-Jie Ma, Feng Ling, Hong-Qi Zhang
BACKGROUND: Spinal epidural arteriovenous fistulas (SEDAVFs) are peculiar and poorly understood lesions with a poorly understood natural history. They are usually subclassified into two types according to their drainage components. This study aimed to describe a new type of SEDAVFs that is featured with a unique drainage pattern and present our natural history hypothesis of SEDAVFs. METHODS: Five SEDAVF cases of the new type were retrospectively reviewed from a high case-volume spinal vascular malformation database...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427975/surgical-management-of-vertex-epidural-hematoma-technical-case-report-and-literature-review
#4
David T Fernandes-Cabral, Ali Kooshkabadi, Sandip S Panesar, Emrah Celtikci, Hamid Borghei-Razavi, Pinar Celtikci, Juan C Fernandez-Miranda
BACKGROUND: Vertex epidural hematoma (VEH) is an uncommon presentation of extra-axial hematomas. It can represent a surgical dilemma regarding when and how to operate, particularly considering the potential implication of the superior sagittal sinus (SSS). OBJECTIVE: Here, we illustrate the surgical technique for VEH as well as review of the existing literature. METHODS: A 60-year-old male sustained a ground level fall resulting in complete diastasis of the sagittal suture with underlying large VEH causing significant mass effect on the SSS and bi-hemispheric convexities...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28416834/-efficacy-of-transforaminal-endoscopic-nerve-root-decompression-in-the-treatment-of-degenerative-lumbar-spinal-stenosis
#5
Z R Yu, C D Li, S N Zhu, H L Sun, Y Zhao, L T Qi
OBJECTIVE: To evaluate the feasibility of transforaminal endoscopic nerve root decompression for degenerative lumbar spinal stenosis (DLSS). METHODS: From July 2011 to April 2016, 96 cases of single segment DLSS were involved. All the patients had unilateral lower extremity neurological symptoms, signs, neurogenic intermittent claudication of less than 500 m. Imaging examinations (CT or MRI) or diagnostic nerve root block confirmed single segment degeneration. The mean age was (71...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28413532/spontaneous-extradural-and-subgaleal-hematoma-a-rare-neurosurgical-crisis-of-sickle-cell-disease
#6
Sudhansu S Mishra, Satya B Senapati, Amiya K Gouda, Sanjay K Behera, Ashis Patnaik
Extradural hematoma (EDH) in absence of trauma is a rare entity with only few cases reported in literature. The various causes reported include: Vascular malformation of dura, coagulopathies, sinus infection, middle ear or orbital infection, and tumor. Occurrence of spontaneous EDH as a complication of sickle cell disease is even much rarer. We report a case with sickle cell disease who presented with spontaneous extradural and subgaleal hematomas following an episode of vaso-oclusive crisis. He was managed successfully with surgery...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28409733/endovascular-management-of-acute-epidural-hematomas-clinical-experience-with-80-cases
#7
Carlos Michel A Peres, Jose Guilherme M P Caldas, Paulo Puglia, Almir F de Andrade, Igor A F da Silva, Manoel J Teixeira, Eberval G Figueiredo
OBJECTIVE Small acute epidural hematomas (EDHs) treated conservatively carry a nonmeasurable risk of late enlargement due to middle meningeal artery (MMA) lesions. Patients with EDHs need to stay hospitalized for several days, with neurological supervision and repeated CT scans. In this study, the authors analyzed the safety and efficacy of the embolization of the involved MMA and associated lesions. METHODS The study group consisted of 80 consecutive patients harboring small- to medium-sized EDHs treated by MMA embolization between January 2010 and December 2014...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28399828/discography-aids-definitive-diagnosis-of-posterior-epidural-migration-of-lumbar-disc-fragments-case-report-and-literature-review
#8
Morito Takano, Tomohiro Hikata, Soraya Nishimura, Michihiro Kamata
BACKGROUND: Posterior epidural migration of lumbar disc fragments (PEMLDF) is extremely rare. It is often confused with other posterior lesions and is usually diagnosed intraoperatively. We here describe the use of preoperative discography in the diagnosis of PEMLDF. CASE PRESENTATION: A 78-year-old man presented with acute low back pain, gait disturbance, and paresthesia in both legs. Magnetic resonance imaging showed a mass located posteriorly and laterally to the left aspect of the dural sac at the L3 level...
April 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28397048/spontaneous-cervical-epidural-hematomas-in-mild-cervical-spondylotic-myelopathy-patients-an-analysis-of-8-cases
#9
Si-Cheng Tang, Yan Wang, Yu Wang, Lei Yang, Jun Chen
Spontaneous cervical epidural hematoms (SCEH) complicated with mild cervical spondylotic myelopathy (CSM) is a rare but emerging condition. Early diagnosis and treatment are important for good outcomes. This study aimed to investigate the clinical characteristics of this condition and to discuss the optimal treatment. The clinical data from 8 patients with SCEH plus CSM who were divided into two groups by treatment methods were retrospectively analyzed. The neurological function of the patients was assessed by Japanese Orthopedic Association (JOA) score before and after the surgical operations...
April 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28385479/opportunity-to-reduce-transfer-of-patients-with-mild-traumatic-brain-injury-and-intracranial-hemorrhage-to-a-level-1-trauma-center
#10
Brian J Yun, Benjamin A White, H Benjamin Harvey, Anand M Prabhakar, Jonathan D Sonis, McKinley Glover, Emily Vallillo, Sun Choi, Pierre Borczuk, Ali S Raja
OBJECTIVE: Current guidelines do not address the disposition of patients with mild traumatic brain injury (TBI) and resultant intracranial hemorrhage (ICH). Emergency medicine clinicians working in hospitals without neurosurgery coverage typically transfer patients with both to a trauma center with neurosurgery capability. Evidence is accruing which demonstrates that the risk of neurologic decompensation depends on the type of ICH and as a result, not every patient may need to be transferred...
March 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28385420/less-is-more-efficacy-of-rapid-3d-t2-space-in-ed-patients-with-acute-atypical-low-back-pain
#11
Nicholas A Koontz, Richard H Wiggins, Megan K Mills, Michael S McLaughlin, Elaine C Pigman, Yoshimi Anzai, Lubdha M Shah
RATIONALE AND OBJECTIVES: Emergency department (ED) patients with acute low back pain (LBP) may present with ambiguous clinical findings that pose diagnostic challenges to exclude cauda equina syndrome (CES). As a proof of concept, we aimed to determine the efficacy of a rapid lumbar spine (LS) magnetic resonance imaging (MRI) screening protocol consisting of a single 3D-T2 SPACE FS (3D-T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution fat saturated) sequence relative to conventional LS MRI to exclude emergently treatable pathologies in this complex patient population...
April 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28383323/risk-of-epidural-hematoma-after-neuraxial-techniques-in-thrombocytopenic-parturients-a-report-from-the-multicenter-perioperative-outcomes-group
#12
Linden O Lee, Brian T Bateman, Sachin Kheterpal, Thomas T Klumpner, Michelle Housey, Michael F Aziz, Karen W Hand, Mark MacEachern, Christopher G Goodier, Jeffrey Bernstein, Melissa E Bauer, Philip Lirk, Janet Wilczak, Roy Soto, Simon Tom, Germaine Cuff, Daniel A Biggs, Traci Coffman, Leif Saager, Warren J Levy, Michael Godbold, Nathan L Pace, Kevin L Wethington, William C Paganelli, Marcel E Durieux, Karen B Domino, Bala Nair, Jesse M Ehrenfeld, Jonathan P Wanderer, Robert B Schonberger, Joshua Berris, Steven Lins, Peter Coles, Kenneth C Cummings, Kamal Maheshwari, Mitchell F Berman, Christopher Wedeven, John LaGorio, Peter M Fleishut, Terri A Ellis, Susan Molina, Curtis Carl, Bassam Kadry, Wilton A van Klei, Wietze Pasma, Leslie C Jameson, Daniel L Helsten, Michael S Avidan
BACKGROUND: Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a systematic review to further define the risk of epidural hematoma requiring surgical decompression in this population. METHODS: The authors performed a retrospective cohort study using the Multicenter Perioperative Outcomes Group database to identify thrombocytopenic parturients who received a neuraxial technique and to estimate the risk of epidural hematoma...
April 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28382256/prognostication-of-traumatic-brain-injury-outcomes-in-older-trauma-patients-a-novel-risk-assessment-tool-based-on-initial-cranial-ct-findings
#13
Stanislaw P Stawicki, Thomas R Wojda, John D Nuschke, Ronnie N Mubang, James Cipolla, William S Hoff, Brian A Hoey, Peter G Thomas, Joan Sweeney, Daniel Ackerman, Jonathan Hosey, Steven Falowski
INTRODUCTION: Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28382214/spontaneous-spinal-epidural-hematoma-management-a-case-series-and-literature-review
#14
Kyle Raasck, Ahmed A Habis, Ahmed Aoude, Leonardo Simões, Fernando Barros, Rudy Reindl, Peter Jarzem
OBJECTIVE: Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord and leading to acute neurological deficits. Standard therapy is decompressive laminectomy, although spontaneous recoveries have been reported. Sub-optimal therapeutic principles contribute to SSEH's 5.7% mortality-which patient will benefit from surgery remains unclear. This study aims to investigate parameters that affect SSEH's progression, outlining a best-practice therapeutic approach...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28379212/effects-of-epidural-compression-on-stellate-neurons-and-thalamocortical-afferent-fibers-in-the-rat-primary-somatosensory-cortex
#15
Tzu-Yin Yeh, Guo-Fang Tseng, Chi-Yu Tseng, Yung-Hsin Huang, Pei-Hsin Liu
A number of neurological disorders such as epidural hematoma can cause compression of cerebral cortex. We here tested the hypothesis that sustained compression of primary somatosensory cortex may affect stellate neurons and thalamocortical afferent (TCA) fibers. A rat model with barrel cortex subjected to bead epidural compression was used. Golgi-Cox staining analyses showed the shrinkage of dendritic arbors and the stripping of dendritic spines of stellate neurons for at least 3 months post-lesion. Anterograde tracing analyses exhibited a progressive decline of TCA fiber density in barrel field for 6 months post-lesion...
2017: Acta Neurobiologiae Experimentalis
https://www.readbyqxmd.com/read/28377250/acute-spinal-epidural-hematoma-after-acupuncture-personal-case-and-literature-review
#16
Maurizio Domenicucci, Daniele Marruzzo, Alessandro Pesce, Antonino Raco, Paolo Missori
BACKGROUND: Spinal acupuncture is a relatively safe and common analgesic treatment, but it may be complicated by serious adverse effects such as direct spinal cord and nerve root injury, subdural empyema and epidural abscesses. In this report we are comparing our case of an extremely uncommon spinal epidural hematoma which appeared following treatment by acupuncture with other similar documented cases. CASE DESCRIPTION: This is the case of a 64-year-old man who presented a left hemiparesis associated with paraesthesias...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28361365/acute-non-traumatic-idiopathic-spinal-subdural-hematoma-radiographic-findings-and-surgical-results-with-a-literature-review
#17
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro
PURPOSE: Intraspinal hematoma is a serious condition, and early diagnosis is necessary to permit emergency treatment. Among such hematomas, non-traumatic spinal subdural hematoma is a rare occurrence. We have experienced three patients with surgically proven subdural spinal hematoma, and here we report these cases with a review of their clinical and imaging characteristics. METHODS: All three cases were idiopathic with no history of disease, no coagulopathy, and no trauma...
March 30, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28357164/subdural-thoracolumbar-spine-hematoma-after-spinal-anesthesia-a-rare-occurrence-and-literature-review-of-spinal-hematomas-after-spinal-anesthesia
#18
REVIEW
Prasanthi Maddali, Blake Walker, Christian Fisahn, Jeni Page, Vicki Diaz, Michael E Zwillman, Rod J Oskouian, R Shane Tubbs, Marc Moisi
Spinal hematomas are a rare but serious complication of spinal epidural anesthesia and are typically seen in the epidural space; however, they have been documented in the subdural space. Spinal subdural hematomas likely exist within a traumatically induced space within the dural border cell layer, rather than an anatomical subdural space. Spinal subdural hematomas present a dangerous clinical situation as they have the potential to cause significant compression of neural elements and can be easily mistaken for spinal epidural hematomas...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28352498/traumatic-cervical-nerve-root-avulsion-with-pseudomeningocele-formation
#19
Ali S Haider, Ian T Watson, Suraj Sulhan, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Cervical nerve root avulsion is a well-documented result of motor vehicle collision (MVC), especially when occurring at high velocities. These avulsions are commonly traction injuries of nerve roots that may be accompanied by a tear in the meninges through the vertebral foramina with associated collections of cerebrospinal fluid (CSF), thereby resulting in a pseudomeningocele. We present a case of a 19-year-old male who experienced an MVC and was brought to the emergency department (ED) with right arm paralysis and other injuries...
February 14, 2017: Curēus
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#20
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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