DOI QR코드

DOI QR Code

The Surgical Treatment of Three Young Chronic Subdural Hematoma Patients with Different Causes

  • Hou, Kun (Department of Neurosurgery, The First Affiliated Hospital of Jilin University) ;
  • Li, Chen G. (Department of Neurosurgery, The First Affiliated Hospital of Jilin University) ;
  • Zhang, Yang (Department of Neurosurgery, The First Affiliated Hospital of Jilin University) ;
  • Zhu, Bo X. (Department of Neurosurgery, The First Affiliated Hospital of Jilin University)
  • Received : 2013.02.19
  • Accepted : 2014.04.15
  • Published : 2014.04.28

Abstract

Chronic subdural hematoma (CSDH), which rarely happens in the young, is thought to be a disease of the elderly. Whereas unspecific symptoms and insidious onset in juveniles and young adults, as a result of its relative low morbidity, CSDH is usually neglected even undertreated in the young. Through the three cases and review of the current literature on this subject, we tried to illustrate the clinical and etiopathological characteristics of this entity and find out the most appropriate treatment strategy. We report three young CSDH patients with different but similar symptoms. The present histories, tests and examinations revealed different predisposing factors accounting for the genesis of CSDH. Their preoperative symptoms were all resolved with burr hole and drainage operation. Juveniles and young adults suffering from CSDH differ from that of their elderly counterparts in their clinical and etiopathological characteristics. Although trauma is the most important risk factor in young and old CSDH patients, some other predisposing factors may exist. Burr hole and drainage surgery could resolve the problem most of the time. But further tests and examinations even specific management should be made in some cases.

Keywords

References

  1. Albanese A, Tuttolomondo A, Anile C, Sabatino G, Pompucci A, Pinto A, et al. : Spontaneous chronic subdural hematomas in young adults with a deficiency in coagulation factor XIII. Report of three cases. J Neurosurg 102 : 1130-1132, 2005 https://doi.org/10.3171/jns.2005.102.6.1130
  2. Albuquerque FC, Giannotta SL : Arachnoid cyst rupture producing subdural hygroma and intracranial hypertension : case reports. Neurosurgery 41 : 951-955; discussion 955-956, 1997 https://doi.org/10.1097/00006123-199710000-00036
  3. Aoki N, Sakai T : Intraoperative subdural hematoma in a patient with arachnoid cyst in the middle cranial fossa. Childs Nerv Syst 6 : 44-46, 1990 https://doi.org/10.1007/BF00262267
  4. Arpino L, Gravina M, Basile D, Franco A : Spontaneous chronic subdural hematoma in a young adult. J Neurosurg Sci 53 : 55-57, 2009
  5. Blank SC, Shakir RA, Bindoff LA, Bradey N : Spontaneous intracranial hypotension : clinical and magnetic resonance imaging characteristics. Clin Neurol Neurosurg 99 : 199-204, 1997 https://doi.org/10.1016/S0303-8467(97)00015-2
  6. Bosma JJ, Miles JB, Shaw MD : Spontaneous chronic and subacute subdural haematoma in young adults. Acta Neurochir (Wien) 142 : 1307- 1310, 2000 https://doi.org/10.1007/s007010070030
  7. Davenport RJ, Chataway SJ, Warlow CP : Spontaneous intracranial hypotension from a CSF leak in a patient with Marfan's syndrome. J Neurol Neurosurg Psychiatry 59 : 516-519, 1995 https://doi.org/10.1136/jnnp.59.5.516
  8. Dillon WP, Fishman RA : Some lessons learned about the diagnosis and treatment of spontaneous intracranial hypotension. AJNR Am J Neuroradiol 19 : 1001-1002, 1998
  9. Ferrante E, Savino A, Sances G, Nappi G : Spontaneous intracranial hypotension syndrome : report of twelve cases. Headache 44 : 615-622, 2004 https://doi.org/10.1111/j.1526-4610.2004.446012.x
  10. Fishman RA, Dillon WP : Dural enhancement and cerebral displacement secondary to intracranial hypotension. Neurology 43 (3 Pt 1) : 609-611, 1993 https://doi.org/10.1212/WNL.43.3_Part_1.609
  11. Fuentes S, Palombi O, Pouit B, Bernard C, Desgeorges M : [Arachnoid cysts of the middle fossa and associated subdural hematoma. Three case reports and review of the literature]. Neurochirurgie 46 : 376-382, 2000
  12. Helland CA, Wester K : A population based study of intracranial arachnoid cysts : clinical and neuroimaging outcomes following surgical cyst decompression in adults. J Neurol Neurosurg Psychiatry 78 : 1129-1135, 2007
  13. Honma S, Fukazawa T, Hamada K, Hamada T, Tashiro K : [MRI changes in spontaneous intracranial hypotension]. Rinsho Shinkeigaku 36 : 912-915, 1996
  14. Ikeda N, Wakabayashi S, Nagao K, Ichioka T, Srivatanakul K, Kajikawa H, et al. : [Two cases of spontaneous intracranial hypotension associated with chronic subdural hematoma only treated with burr hole irrigation of the hematomas]. No To Shinkei 57 : 701-707, 2005
  15. Kotwica Z, Polis L : The association of arteriovenous malformation, aneurysm and chronic subdural hematoma. Case report. Zentralbl Neurochir 47 : 158-160, 1986
  16. Missori P, Maraglino C, Tarantino R, Salvati M, Calderaro G, Santoro A, et al. : Chronic subdural haematomas in patients aged under 50. Clin Neurol Neurosurg 102 : 199-202, 2000 https://doi.org/10.1016/S0303-8467(00)00102-5
  17. Mokri B, Piepgras DG, Miller GM : Syndrome of orthostatic headaches and diffuse pachymeningeal gadolinium enhancement. Mayo Clin Proc 72 : 400-413, 1997 https://doi.org/10.4065/72.5.400
  18. Mori K, Yamamoto T, Horinaka N, Maeda M : Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles : twelve cases of chronic subdural hematoma associated with arachnoid cyst. J Neurotrauma 19 : 1017-1027, 2002 https://doi.org/10.1089/089771502760341938
  19. Murakami M, Morikawa K, Matsuno A, Kaneda K, Nagashima T : Spontaneous intracranial hypotension associated with bilateral chronic subdural hematomas--case report. Neurol Med Chir (Tokyo) 40 : 484-488, 2000 https://doi.org/10.2176/nmc.40.484
  20. Nakajima H, Sakai T, Aoki N, Takakura K : Bilateral chronic subdural hematomas associated with intracranial hypotension--case report. Neurol Med Chir (Tokyo) 36 : 647-649, 1996 https://doi.org/10.2176/nmc.36.647
  21. Nosik WA : Intracranial hypotension secondary to lumbar nerve sleeve tear. J Am Med Assoc 157 : 1110-1111, 1955 https://doi.org/10.1001/jama.1955.02950300038008
  22. Oka Y, Kumon Y, Ohta S, Sakaki S, Ohue S, Takeda S : Chronic subdural hematoma associated with middle fossa arachnoid cysts--three case reports. Neurol Med Chir (Tokyo) 34 : 95-99, 1994 https://doi.org/10.2176/nmc.34.95
  23. Page A, Paxton RM, Mohan D : A reappraisal of the relationship between arachnoid cysts of the middle fossa and chronic subdural haematoma. J Neurol Neurosurg Psychiatry 50 : 1001-1007, 1987 https://doi.org/10.1136/jnnp.50.8.1001
  24. Schievink WI, Meyer FB, Atkinson JL, Mokri B : Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. J Neurosurg 84 : 598-605, 1996 https://doi.org/10.3171/jns.1996.84.4.0598
  25. Schievink WI, Morreale VM, Atkinson JL, Meyer FB, Piepgras DG, Ebersold MJ : Surgical treatment of spontaneous spinal cerebrospinal fluid leaks. J Neurosurg 88 : 243-246, 1998 https://doi.org/10.3171/jns.1998.88.2.0243
  26. Servadei F, Vergoni G, Frattarelli M, Pasini A, Arista A, Fagioli L : Arachnoid cyst of middle cranial fossa and ipsilateral subdural haematoma : diagnostic and therapeutic implications in three cases. Br J Neurosurg 7 : 249-253, 1993 https://doi.org/10.3109/02688699309023806
  27. Strupp M, Katsarava Z : [Post-lumbar puncture syndrome and spontaneous low CSF pressure syndrome]. Nervenarzt 80 : 1509-1519, 2009 https://doi.org/10.1007/s00115-009-2833-y
  28. Takahashi T, Senbokuya N, Horikoshi T, Sato E, Nukui H, Kinouchi H : [Refractory chronic subdural hematoma due to spontaneous intracranial hypotension]. No Shinkei Geka 35 : 799-806, 2007
  29. Tseng YL, Chang YY, Lan MY, Wu HS, Liu JS : Spontaneous intracranial hypotension in a patient with reversible pachymeningeal enhancement and brain descent. Chang Gung Med J 26 : 293-298, 2003
  30. Umebayashi D, Takado M, Osaka Y, Nakahara Y, Tenjin H : [Two cases of spontaneous intracranial hypotension with bilateral chronic subdural hematomas]. Brain Nerve 63 : 171-175, 2011

Cited by

  1. Sport-related structural brain injury associated with arachnoid cysts: a systematic review and quantitative analysis vol.40, pp.4, 2016, https://doi.org/10.3171/2016.1.focus15608
  2. Clinical Course in Chronic Subdural Hematoma Patients Aged 18–49 Compared to Patients 50 Years and Above: A Multicenter Study and Meta-Analysis vol.10, pp.None, 2019, https://doi.org/10.3389/fneur.2019.00311