Subdural Effusion
Hematoma, Subdural
Empyema, Subdural
Intracranial Hypotension
Hematoma, Subdural, Chronic
Pleural Effusion
Hematoma, Subdural, Acute
Pericardial Effusion
Pleural Effusion, Malignant
Diagnosis and management of subdural haematoma complicating bone marrow transplantation. (1/57)
Subdural haematoma (SDH) is a known complication of bone marrow transplantation (BMT). A retrospective review of 657 consecutive patients undergoing allogeneic or autologous bone marrow/stem cell transplantation at the Royal Brisbane Hospital between January 1991 and December 1998 is reported. Seventeen cases of subdural haematoma/hygroma were identified (2.6%). Eleven of these (65%) were bilateral. Four required surgical drainage, with two developing re-accumulation of SDH. All cases presented with a headache and eight of these had associated neurological complications. Diagnosis was made predominately by CT scan: however in 25% of cases definitive diagnosis could only be made in MRI studies. An association with intrathecal methorexate-containing conditioning therapy, post lumbar puncture headache, prolonged thrombocytopenia and coagulopathy was noted. In our experience, conservative management with platelet support and correction of coagulopathy achieved resolution of subdural haematoma in most cases, with surgical intervention being reserved for neurological deterioration. Bone Marrow Transplantation (2000) 25, 549-552. (+info)Intracranial hypotension due to cerebrospinal fluid leakage detected by radioisotope cisternography. (2/57)
Seven patients, six females and one male aged 26 to 39 years old, presented with headache in the upright posture, which was completely relieved in the recumbent posture. Radioisotope cisternography with technetium-99m-human serum albumin detected cerebrospinal fluid (CSF) leakage at the cervicothoracic level in six patients, and at the high cervical level in one patient. The diagnosis was intracranial hypotension due to spontaneous CSF leakage. Complete bed rest for more than 2 weeks resulted in complete resolution of the headache in all patients, and follow-up cisternography showed no leakage. Radioisotope cisternography is useful for the diagnosis of spontaneous CSF leakage, and complete bed rest for more than 2 weeks may be the best method of treatment. (+info)The fate of traumatic subdural hygroma in serial computed tomographic scans. (3/57)
We reviewed serial computed tomographic (CT) scans of 58 patients with traumatic subdural hygroma (SDG) to investigate its natural history. All were re-evaluated with a special reference to the size and density of SDG. Thirty-four patients (58.6%) were managed conservatively and 24 patients (41.4%) underwent surgery. The lesion was described as remained, reduced, resolved, enlarged and changed. Means of interval from injury to diagnosis and any changes in CT were calculated. SDGs were resolved in 12 (20.7%), reduced in 15 (25.9%), remained in 10 (17.2%), enlarged in 2 (3.4%), and changed into chronic subdural hematoma (CSDH) in 19 patients (32.8%). SDG was diagnosed at 11.6 days after the injury. It was enlarged at 25.5 days, remained at 46.0 days, reduced at 59.3 days, resolved at 107.5 days, and changed into CSDH at 101.5 days in average. SDGs were developed as delayed lesions, and changed sequentially. They enlarged for a while, then reduced in size. The final path of a SDG was either resolution or CSDH formation. Nearly half of SDGs was resolved or reduced within three months, however, 61.3% of unresolved or unreduced SDG became iso- or hyperdense CSDH. These results suggest that the unresolved SDG is the precursor of CSDH. (+info)Multi-level disruption of the spinal nerve root sleeves in spontaneous spinal cerebrospinal fluid leakage--two case reports. (4/57)
A 37-year-old male and an 18-year-old male presented with spontaneous spinal cerebrospinal fluid (CSF) leakage from multiple nerve root sleeves. Both patients suffered abrupt onset of intense headache followed by nausea, dizziness, and one patient with and one without positional headache. Radioisotope spinal cisternography of both patients revealed that the CSF leaks were not localized in a special zone but distributed to multiple spinal nerve root sleeves. Magnetic resonance (MR) myelography suggested that the spinal CSF column was fully expanded to the root sleeves. The extraspinal nerve bundles demonstrated numerous high intensity spots. Both patients were treated conservatively, and their symptoms resolved within one month. Repeat radioisotope cisternography and MR myelography confirmed the spine was normal after recovery. We suggest that spreading disruption of the arachnoid membrane occurs at the nerve root sleeves due to CSF overflow into the spinal canal. (+info)Transoral transclival approach for intradural lesions using a protective bone baffle to block cerebrospinal fluid pulse energy--two case reports. (5/57)
The transoral transclival approach for the treatment of intradural lesions of the clivus is often associated with serious complications such as cerebrospinal fluid (CSF) leakage and meningitis. CSF pulse energy may be the most significant factor in CSF leakage and meningitis, but a bone baffle can block such CSF pulse energy. A 64-year-old female presented with sudden onset of severe headache. She had subarachnoidal hemorrhage due to a rupture of the vertebral-posterior inferior cerebellar artery aneurysm. A 66-year-old female complaining of occipitalgia and numbness of the extremities had a foramen magnum meningioma. Both patients were treated via the transoral transclival route with a protective bone baffle, obtained from the iliac bone, securely fixed in the bone window to protect the repaired dura from injury by CSF pulse energy. Neither patient showed CSF leakage or meningitis, and the period of continuous lumbar CSF drainage was only 7 days. The transoral transclival approach with a bone baffle is still very effective in selected cases. (+info)Bilateral subdural effusion and subcutaneous swelling with normally functioning csf shunt. (6/57)
We report a child with hydrocephalus due to tuberculous meningitis who developed a subcutaneous fluid collection around the ventriculoperitoneal shunt tube entry point, after one month of shunting. On investigation, he had decompressed ventricles with bilateral fronto parietal subdural hygroma. Bifrontal burr hole drainage helped resolution of both subdural effusion and subcutaneous scalp swelling. This complication is unique and its pathogenesis has been postulated. (+info)Cerebral cysticercus granuloma associated with a subdural effusion. (7/57)
The association of a solitary cerebral cysticercus granuloma with a subdural effusion is being reported. The granuloma and the effusion resolved following albendazole therapy. We speculate that the spread of the inflammatory changes around the granuloma to the subdural space could have led to the development of the subdural effusion. (+info)Should the new pneumococcal vaccine be used in high-risk children? (8/57)
A new conjugate 7-valent vaccine to prevent pneumococcal infection (Prevenar, Wyeth) has recently received a European licence for use in young healthy children. The vaccine is not currently included in the universal immunisation schedule in the UK or elsewhere in Europe, although it is being used widely in the USA. Its availability for purchase raises the question whether paediatricians should consider using it in high risk children, including those for whom the polysaccharide 23-valent vaccine was previously recommended, until (or unless) it is introduced into general use-indeed the Chief Medical Officer for England and Wales has recently made a recommendation regarding such children aged less than 2 years. We review the evidence concerning use of the vaccine in such children and make suggestions as to how the vaccine may be used while further information is collected. (+info)A subdural effusion is an abnormal accumulation of fluid in the potential space between the dura mater (the outermost layer of the meninges that covers the brain and spinal cord) and the arachnoid membrane (one of the three layers of the meninges that surround the brain and spinal cord) in the subdural space.
Subdural effusions can occur due to various reasons, including head trauma, infection, or complications from neurosurgical procedures. The fluid accumulation may result from bleeding (subdural hematoma), inflammation, or increased cerebrospinal fluid pressure. Depending on the underlying cause and the amount of fluid accumulated, subdural effusions can cause various symptoms, such as headaches, altered mental status, or neurological deficits.
Subdural effusions are often asymptomatic and may resolve independently; however, in some cases, medical intervention might be necessary to alleviate the pressure on the brain or address the underlying condition. Imaging techniques like computed tomography (CT) or magnetic resonance imaging (MRI) scans are typically used to diagnose and monitor subdural effusions.
The subdural space is a potential space between the dura mater, which is the outermost of the three meninges covering the brain and spinal cord, and the arachnoid mater, which is the middle meningeal layer. This space normally contains a thin film of fluid, but when it becomes filled with blood (subdural hematoma) or pus (subdural empyema), it can cause significant neurological problems due to increased pressure on the brain. The subdural space can also become widened in certain conditions such as dementia or hydrocephalus, leading to a condition called subdural hygroma.
A subdural hematoma is a type of hematoma (a collection of blood) that occurs between the dura mater, which is the outermost protective covering of the brain, and the brain itself. It is usually caused by bleeding from the veins located in this potential space, often as a result of a head injury or trauma.
Subdural hematomas can be classified as acute, subacute, or chronic based on their rate of symptom progression and the time course of their appearance on imaging studies. Acute subdural hematomas typically develop and cause symptoms rapidly, often within hours of the head injury. Subacute subdural hematomas have a more gradual onset of symptoms, which can occur over several days to a week after the trauma. Chronic subdural hematomas may take weeks to months to develop and are often seen in older adults or individuals with chronic alcohol abuse, even after minor head injuries.
Symptoms of a subdural hematoma can vary widely depending on the size and location of the hematoma, as well as the patient's age and overall health. Common symptoms include headache, altered mental status, confusion, memory loss, weakness or numbness, seizures, and in severe cases, coma or even death. Treatment typically involves surgical evacuation of the hematoma, along with management of any underlying conditions that may have contributed to its development.
Empyema subdural is a medical condition characterized by the presence of pus (purulent material) in the potential space between the dura mater and the arachnoid membrane of the brain. This space is called the subdural space. Empyema subdural can result from an infection that spreads from nearby areas such as the skull, face, or sinuses, or it can occur as a complication of neurosurgical procedures.
The symptoms of empyema subdural may include headache, altered mental status, fever, seizures, and neurological deficits depending on the severity and location of the infection. Diagnosis is usually made with the help of imaging studies such as CT or MRI scans, and treatment typically involves surgical drainage of the pus along with antibiotic therapy to eliminate the underlying infection. If left untreated, empyema subdural can lead to serious complications such as brain abscess, meningitis, or even death.
Intracranial hypotension is a medical condition characterized by reduced pressure within the cranial cavity (the space containing brain and cerebrospinal fluid). This can occur due to several reasons, most commonly being a spontaneous or traumatic CSF leak (cerebrospinal fluid leak) from the dural membrane that surrounds the brain and spinal cord. The decrease in CSF pressure can cause various symptoms such as headaches (often positional), nausea, vomiting, neck pain, blurred vision, ringing in the ears, and cognitive impairment. Treatment typically involves identifying and addressing the underlying cause, which may include bed rest, hydration, caffeine, epidural blood patch procedures, or surgical repair of CSF leaks.
A subdural hematoma (SDH) is a type of intracranial hemorrhage that occurs between the dura mater and the brain. When it becomes chronic, it means that the bleeding has occurred slowly over time, often over the course of several weeks or months. The blood gradually collects in the potential space between the dura and the arachnoid membrane, forming a clot.
A chronic subdural hematoma (CSDH) is typically characterized by the presence of liquefied blood, which can form a loculated collection that may exert mass effect on the underlying brain tissue. This can lead to symptoms such as headache, confusion, weakness, or even seizures, depending on the size and location of the hematoma.
CSDHs are often associated with underlying brain atrophy, which can create a larger potential space for blood to collect. They may also be seen in patients who are taking anticoagulant medications or have a bleeding disorder. Treatment typically involves surgical evacuation of the hematoma, although smaller CSDHs may be managed conservatively with close monitoring and repeat imaging.
Pleural effusion is a medical condition characterized by the abnormal accumulation of fluid in the pleural space, which is the thin, fluid-filled space that surrounds the lungs and lines the inside of the chest wall. This space typically contains a small amount of fluid to allow for smooth movement of the lungs during breathing. However, when an excessive amount of fluid accumulates, it can cause symptoms such as shortness of breath, coughing, and chest pain.
Pleural effusions can be caused by various underlying medical conditions, including pneumonia, heart failure, cancer, pulmonary embolism, and autoimmune disorders. The fluid that accumulates in the pleural space can be transudative or exudative, depending on the cause of the effusion. Transudative effusions are caused by increased pressure in the blood vessels or decreased protein levels in the blood, while exudative effusions are caused by inflammation, infection, or cancer.
Diagnosis of pleural effusion typically involves a physical examination, chest X-ray, and analysis of the fluid in the pleural space. Treatment depends on the underlying cause of the effusion and may include medications, drainage of the fluid, or surgery.
A subdural hematoma is a type of brain injury in which blood accumulates between the dura mater (the outermost layer of the meninges, the protective coverings of the brain and spinal cord) and the brain. In the case of an acute subdural hematoma, the bleeding occurs suddenly and rapidly as a result of trauma, such as a severe head injury from a fall, motor vehicle accident, or assault. The accumulation of blood puts pressure on the brain, which can lead to serious complications, including brain damage or death, if not promptly diagnosed and treated. Acute subdural hematomas are considered medical emergencies and require immediate neurosurgical intervention.
Pericardial effusion is an abnormal accumulation of fluid in the pericardial space, which is the potential space between the two layers of the pericardium - the fibrous and serous layers. The pericardium is a sac that surrounds the heart to provide protection and lubrication for the heart's movement during each heartbeat. Normally, there is only a small amount of fluid (5-15 mL) in this space to ensure smooth motion of the heart. However, when an excessive amount of fluid accumulates, it can cause increased pressure on the heart, leading to various complications such as decreased cardiac output and even cardiac tamponade, a life-threatening condition that requires immediate medical attention.
Pericardial effusion may result from several causes, including infections (viral, bacterial, or fungal), inflammatory conditions (such as rheumatoid arthritis, lupus, or cancer), trauma, heart surgery, kidney failure, or iatrogenic causes. The symptoms of pericardial effusion can vary depending on the rate and amount of fluid accumulation. Slowly developing effusions may not cause any symptoms, while rapid accumulations can lead to chest pain, shortness of breath, cough, palpitations, or even hypotension (low blood pressure). Diagnosis is usually confirmed through imaging techniques such as echocardiography, CT scan, or MRI. Treatment depends on the underlying cause and severity of the effusion, ranging from close monitoring to drainage procedures or medications to address the root cause.
Malignant pleural effusion is a medical condition characterized by the abnormal accumulation of fluid in the pleural space (the area between the lungs and the chest wall) due to the spread of malignant (cancerous) cells from a primary tumor located elsewhere in the body. This type of effusion is typically associated with advanced-stage cancer, and it can cause symptoms such as shortness of breath, coughing, and chest pain. The presence of malignant pleural effusion often indicates a poor prognosis, and treatment is generally focused on palliating symptoms and improving quality of life.
A subdural hematoma in the spine is a specific type of spinal hemorrhage, where blood accumulates in the potential space between the dura mater (the outer layer of the meninges that covers the brain and spinal cord) and the arachnoid membrane (the middle layer of the meninges). This space is normally devoid of fluid or blood.
Subdural hematomas in the spine can result from trauma, such as a fall or motor vehicle accident, which causes bleeding from the venous vessels located between the dura mater and arachnoid membrane. As blood accumulates, it can compress the spinal cord and nerve roots, leading to neurological deficits.
Symptoms of a subdural hematoma in the spine may include localized back pain, radiating pain, sensory loss, motor weakness, or paralysis below the level of the lesion. In severe cases, it can lead to respiratory failure, loss of bowel and bladder control, and even death if not promptly diagnosed and treated.
Otitis media with effusion (OME), also known as serous otitis media or glue ear, is a medical condition characterized by the presence of fluid in the middle ear without signs or symptoms of acute ear infection. The fluid accumulation occurs due to the dysfunction of the Eustachian tube, which results in negative pressure and subsequent accumulation of sterile fluid within the middle ear space.
OME can lead to hearing difficulties, especially in children, as the fluid buildup impairs sound conduction through the ossicles in the middle ear. Symptoms may include mild hearing loss, tinnitus (ringing in the ears), and a sensation of fullness or pressure in the affected ear. In some cases, OME can resolve on its own within a few weeks or months; however, persistent cases might require medical intervention, such as placement of tympanostomy tubes (ear tubes) to drain the fluid and restore hearing.