OBJECTIVES: To study the correlation between CT imaging features of acceleration and deceleration brain injury and injury degree. METHODS: A total of 299 cases with acceleration and deceleration brain injury were collected and divided into acceleration brain injury group and deceleration brain injury group according to the injury mechanism. Subarachnoid hemorrhage (SAH) and Glasgow coma scale (GCS), combined with skull fracture, epidural hematoma (EDH), subdural hematoma (SDH) and brain contusion on the same and opposite sides of the stress point were selected as the screening indexes. χ² test was used for primary screening, and binary logistic regression analysis was used for secondary screening. The indexes with the strongest correlation in acceleration and deceleration injury mechanism were selected. RESULTS: χ² test showed that skull fracture and EDH on the same side of the stress point; EDH, SDH and brain contusion on the opposite of the stress point; SAH, GCS were correlated with acceleration and deceleration injury (P<0.05). According to binary logistic regression analysis, the odds ratio (OR) of EDH on the same side of the stress point was 2.697, the OR of brain contusion on the opposite of the stress point was 0.043 and the OR of GCS was 0.238, suggesting there was statistically significant (P<0.05). CONCLUSIONS EDH on the same side of the stress point, brain contusion on the opposite of the stress point and GCS can be used as key indicators to distinguish acceleration and deceleration injury mechanism. In addition, skull fracture on the same side of the stress point, EDH and SDH on the opposite of the stress point and SAH were relatively weak indicators in distinguishing acceleration and deceleration injury mechanism.
Brain Contusion ; Brain Injuries/diagnostic imaging* ; Hematoma, Epidural, Cranial ; Hematoma, Subdural/etiology* ; Humans ; Logistic Models ; Skull Fractures/diagnostic imaging* ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/diagnostic imaging*

Fibrosis ; Hematoma, Subdural ; Humans ; Osteogenesis ; Subdural Space ; Tomography, X-Ray Computed

Death ; Hematoma, Subdural/etiology* ; Humans ; Syphilis, Congenital/complications*

Most cases of spinal subdural hematoma are very rare and result from iatrogenic causes, such as coagulopathy or a spinal puncture. Cases of non-traumatic spinal subdural hematoma accompanied by intracranial hemorrhage are even more rare. There are a few reports of spontaneous spinal subdural hematoma with concomitant intracranial subdural or subarachnoid hemorrhage, but not with intracerebral hemorrhage. Especially in our case, the evaluation and diagnosis were delayed because the spontaneous intracerebral hemorrhage accompanying the unilateral spinal subdural and subarachnoid hemorrhages caused hemiplegia. We report a case of spinal subdural and subarachnoid hemorrhage with concomitant intracerebral hemorrhage, for the first time, with a relevant literature review.
Cerebral Hemorrhage ; Diagnosis ; Hematoma ; Hematoma, Subdural, Spinal ; Hemiplegia ; Intracranial Hemorrhages ; Spinal Puncture ; Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) usually occurs due to aneurysmal rupture of intracranial arteries and its typical computed tomography (CT) findings are increased attenuation of cisterns and subarachnoid spaces. However, several CT findings mimicking SAH are feasible in diverse conditions. They are so-called as pseudo-SAH, and this report is a case of pseudo-SAH which is misdiagnosed as aneurysm rupture accompanied by bilateral chronic subdural hematoma (cSDH). A 42-year-old male with severe headache visited our institute. Non-contrast brain CT images showed increased attenuation on basal cistern, and cSDH on both fronto-temporo-parietal convexity with midline shifting. Trans-femoral cerebral angiography was done and we confirmed small aneurysm at right M1 portion of middle cerebral artery. Under diagnosis of SAH, we planned an operation in order to clip aneurysmal neck and remove cSDH. cSDH was removed as planned, however, there was no SAH and we also couldn't find the rupture point of aneurysm. Serial follow-up CT showed mild cumulative cSDH recurrence, but the patient was tolerant and had no neurologic deficit during hospitalization. We have checked the patient via out-patient department for 6 months, there are no significant changes in volume and density of cSDH and the patient also have no neurologic complications.
Adult ; Aneurysm ; Arteries ; Brain ; Brain Edema ; Cerebral Angiography ; Diagnosis ; Follow-Up Studies ; Headache ; Hematoma, Subdural, Chronic ; Hemorrhage ; Hospitalization ; Humans ; Intracranial Hypertension ; Male ; Middle Cerebral Artery ; Neck ; Neurologic Manifestations ; Outpatients ; Recurrence ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Space

No abstract available.
Hematoma, Subdural, Chronic

No abstract available.
Hematoma, Subdural, Chronic

Spinal subdural hematoma (SDH) is rarely reported, and their simultaneous occurrence with intracranial SDH is even more rare. A 67-year-old male patient with a history of posterolateral fusion to treat an L2 burst fracture came to our outpatient clinic due to an inability to walk by himself over the previous 3 weeks. A neurological examination revealed that the patient was alert with occasional confusion and slight motor weakness in the lower extremities. Brain and lumbar spine magnetic resonance imaging (MRI) was then performed. A brain MRI revealed a large subacute SDH along the right cerebral convexity and falx cerebri with midline shifting, and a spine MRI revealed a right side-predominant subacute SDH extending from L4 to S1. For treatment, burr hole trephination of the intracranial SDH and fluoroscopy-guided lumbar puncture of the spinal SDH were performed and resulted in a favorable outcome. This is a report of a rare case of spontaneous intracranial and lumbar spine SDH. We include a review of the current literature and a discussion of the pathogenesis of this condition in this report.
Aged ; Ambulatory Care Facilities ; Brain ; Hematoma, Subdural ; Hematoma, Subdural, Spinal ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Spinal Cord ; Spinal Puncture ; Spine ; Trephining

We report 3 cases of arachnoid cysts (ACs) that completely disappeared after burr hole drainage, without cyst fenestration into the subarachnoid space or cystoperitoneal shunt. The first patient was a 21-year-old female with an AC of the right cerebral convexity, found incidentally. After endoscopic AC fenestration was performed, the patient complained of persistent headache. Two-month postoperative brain imaging revealed reaccumulated AC and associated multi-stage subdural hematoma. Burr hole drainage was performed to resolve the chronic subdural hematoma (CSDH). Three months later, brain computed tomography showed that the CSDH and the AC had disappeared. The second patient was an 11-year-old male who had a history of trauma 1 month prior to presentation at the clinic. Brain magnetic resonance imaging revealed an AC in the left sylvian fissure with CSDH. We performed burr hole drainage to treat the CSDH first. Subsequently, the AC as well as the CSDH disappeared. The third case was an AC of the right parietal convexity, found incidentally. Only burr hole drainage was performed, following which, the AC disappeared. This case series shows that an AC can disappear naturally after rupture into the subdural space by trauma or the burr hole procedure.
Arachnoid Cysts ; Arachnoid ; Brain ; Child ; Drainage ; Female ; Headache ; Hematoma, Subdural ; Hematoma, Subdural, Chronic ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroimaging ; Rabeprazole ; Rupture ; Subarachnoid Space ; Subdural Space ; Trephining ; Young Adult

A 57-year-old male had cardiac arrest during an operation of traumatic acute subdural haematoma (ASDH) and intraparenchymal haemorrhage in the infratentorium due to a great amount of bleeding from the pre-injured venous sinus. After effective bleeding control using a gauze, the patient recovered without additional neurological sequelae. The operation of traumatic ASDH in the infratentorium always poses a risk of excessive bleeding from the injured venous sinus that could be life-threatening to the patient. This risk could be avoided with the effective first method that can immediately control the bleeding.
Heart Arrest ; Hematoma, Subdural, Acute ; Hemorrhage ; Humans ; Male ; Methods ; Middle Aged