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Current diagnosis and treatment of chronic subdural haematomas.

Iliescu IA - J Med Life (2015 Jul-Sep)

Bottom Line: Although the surgical treatment presents a categorical indication in most of the cases, the fact that there are many surgical techniques, a great relapse rate, as well as the numerous studies, which try to highlight the efficiency of a technique as compared to another, demonstrate that the treatment of these haematomas is far from reaching a consensus among the neurosurgeons.The latest conservatory treatment directions are still being studied and need many years to be confirmed.CT = computerized tomography, MRI = magnetic resonance imaging.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, University Hospital Bucharest, Romania.

ABSTRACT

Unlabelled: A developed society is usually also characterized by an elderly population, which has a continuous percentage growth. This population frequently presents a cumulus of medical pathologies. With the development of the medication and surgical treatment of different affections, the life span has increased and the pathology of an old patient has diversified as far as the cumulus of various pathological diseases in the same person is concerned. Chronic subdural pathologies represent an affection frequently met in neurosurgery practice. Any neurosurgeon, neurologist and not only, has to be aware of the possibility of the existence of a chronic subdural haematoma, especially when the patient is old and is subjected to an anticoagulant or antiaggregant treatment, these 2 causes being by far the etiological factors most frequently met in chronic subdural haematomas. With an adequate diagnosis and treatment, usually surgical, the prognosis is favorable. Although the surgical treatment presents a categorical indication in most of the cases, the fact that there are many surgical techniques, a great relapse rate, as well as the numerous studies, which try to highlight the efficiency of a technique as compared to another, demonstrate that the treatment of these haematomas is far from reaching a consensus among the neurosurgeons. The latest conservatory treatment directions are still being studied and need many years to be confirmed.

Abbreviations: CT = computerized tomography, MRI = magnetic resonance imaging.

No MeSH data available.


Related in: MedlinePlus

Bilateral chronic subdural haematoma; what should be taken into account is the absence of the mass effect on the structures of the median line, and the presence of the compressive effect on the noble brain structures – MRI image, T1
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Figure 3: Bilateral chronic subdural haematoma; what should be taken into account is the absence of the mass effect on the structures of the median line, and the presence of the compressive effect on the noble brain structures – MRI image, T1

Mentions: This way the cerebrospinal fluid, the bone, the rapid blood flow and the air, appear as being black or in different shades of black in T1. The cerebral gray matter and the white substance appear in T1 in different shades of gray. The fat and the recent blood effusions emit a strong signal, these being white in T1. In T2, the images are clearer, reflecting the modifications in the water content. In addition, the structures that contain a large amount of water appear with a strong signal, being white, as for example the cerebrospinal fluid (CSF), cerebral edema, demyelinated areas, tumors with a content characterized by a large amount of water. Due to the fact that the bone does not contain water, it appears as being black and its anatomical details are visualized harder than in a CT scan or in the images of an MRI in T1 (Fig. 3,4).


Current diagnosis and treatment of chronic subdural haematomas.

Iliescu IA - J Med Life (2015 Jul-Sep)

Bilateral chronic subdural haematoma; what should be taken into account is the absence of the mass effect on the structures of the median line, and the presence of the compressive effect on the noble brain structures – MRI image, T1
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556906&req=5

Figure 3: Bilateral chronic subdural haematoma; what should be taken into account is the absence of the mass effect on the structures of the median line, and the presence of the compressive effect on the noble brain structures – MRI image, T1
Mentions: This way the cerebrospinal fluid, the bone, the rapid blood flow and the air, appear as being black or in different shades of black in T1. The cerebral gray matter and the white substance appear in T1 in different shades of gray. The fat and the recent blood effusions emit a strong signal, these being white in T1. In T2, the images are clearer, reflecting the modifications in the water content. In addition, the structures that contain a large amount of water appear with a strong signal, being white, as for example the cerebrospinal fluid (CSF), cerebral edema, demyelinated areas, tumors with a content characterized by a large amount of water. Due to the fact that the bone does not contain water, it appears as being black and its anatomical details are visualized harder than in a CT scan or in the images of an MRI in T1 (Fig. 3,4).

Bottom Line: Although the surgical treatment presents a categorical indication in most of the cases, the fact that there are many surgical techniques, a great relapse rate, as well as the numerous studies, which try to highlight the efficiency of a technique as compared to another, demonstrate that the treatment of these haematomas is far from reaching a consensus among the neurosurgeons.The latest conservatory treatment directions are still being studied and need many years to be confirmed.CT = computerized tomography, MRI = magnetic resonance imaging.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, University Hospital Bucharest, Romania.

ABSTRACT

Unlabelled: A developed society is usually also characterized by an elderly population, which has a continuous percentage growth. This population frequently presents a cumulus of medical pathologies. With the development of the medication and surgical treatment of different affections, the life span has increased and the pathology of an old patient has diversified as far as the cumulus of various pathological diseases in the same person is concerned. Chronic subdural pathologies represent an affection frequently met in neurosurgery practice. Any neurosurgeon, neurologist and not only, has to be aware of the possibility of the existence of a chronic subdural haematoma, especially when the patient is old and is subjected to an anticoagulant or antiaggregant treatment, these 2 causes being by far the etiological factors most frequently met in chronic subdural haematomas. With an adequate diagnosis and treatment, usually surgical, the prognosis is favorable. Although the surgical treatment presents a categorical indication in most of the cases, the fact that there are many surgical techniques, a great relapse rate, as well as the numerous studies, which try to highlight the efficiency of a technique as compared to another, demonstrate that the treatment of these haematomas is far from reaching a consensus among the neurosurgeons. The latest conservatory treatment directions are still being studied and need many years to be confirmed.

Abbreviations: CT = computerized tomography, MRI = magnetic resonance imaging.

No MeSH data available.


Related in: MedlinePlus