Journal of Trauma and Injury

Spontaneous intracranial hypotension in young and middle-aged patients with chronic subdual hematoma in Korea: three case reports: Ae Ryoung Lee, Yun Suk Choi; J Trauma Inj. 2024;37(3):228-232. Published online August 8, 2024; DOI: https://doi.org/10.20408/jti.2024.0008

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Abstract PDF: This case series highlights chronic subdural hematoma in previously healthy young and middle-aged patients, where symptoms persisted despite initial surgical intervention. Subsequent diagnosis revealed spontaneous intracranial hypotension through computed tomography myelography. All patients experienced symptom relief after undergoing epidural blood patch. In conclusion, spontaneous intracranial hypotension should be considered in chronic subdural hematoma cases without trauma or underlying disease, with epidural blood patch recommended before surgical intervention if spontaneous intracranial hypotension is suspected.; Summary

Surgical management of supratentorial and infratentorial epidural hematoma in Korea: three case reports: Su Young Yoon, Junepill Seok, Yook Kim, Jin Suk Lee, Jin Young Lee, Mou Seop Lee, Hong Rye Kim; J Trauma Inj. 2023;36(4):399-403. Published online December 26, 2023; DOI: https://doi.org/10.20408/jti.2023.0073

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Abstract PDF: Supratentorial and infratentorial epidural hematoma (SIEDH) is a rare but life-threatening complication following traumatic brain injury. However, the literature on SIEDH is sparse, consisting only of a few small series. Prompt diagnosis and the application of appropriate surgical techniques are crucial for the rapid and safe management of SIEDH. Herein, we present three cases of SIEDH treated at our institution, employing a range of surgical approaches.; Summary

Chronic epidural hematoma evacuated through surgical treatment: a case report: Eui Gyu Sin; J Trauma Inj. 2022;35(1):43-45. Published online March 21, 2022; DOI: https://doi.org/10.20408/jti.2021.0036

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Epidural hematoma (EDH) can sometimes be life-threatening, although small-volume EDHs can resolve spontaneously like other intracranial hematomas. However, in rare cases, EDH can transform into a chronic form instead of disappearing. In contrast to subdural hematoma, there is no agreed-upon definition or treatment of chronic EDH. A 41-year-old male patient with acute EDH in the bilateral paravertical area due to partial rupture of the sagittal sinus was operated first, and then remnant contralateral hematoma was treated conservatively. One month after surgery, he showed hemiparesis, and brain imaging revealed chronic EDH at the location of the remnant acute hematoma. We performed surgery again to treat chronic EDH through a large craniotomy. Although many cases of EDH are self-limited, clinicians must keep in mind that some cases of EDH, especially those of venous origin and arising in young people, can become chronic and require surgical treatment.

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Citations

Citations to this article as recorded by

Chronic Epidural Hematoma in an Elderly Patient: A Rare Encounter!!
Sharmistha Pathak, Surya K. Dube, Vanitha Rajagopalan, Navdeep Sokhal
Journal of Neuroanaesthesiology and Critical Care.2024;[Epub] CrossRef
Chronic epidural hematoma: a systematic review and meta-analysis
Nicaise Kpègnon Agada, Nourou Dine Adeniran Bankole, Mèhomè Wilfried Dossou, Omar Boladji Adébayo Badirou, Emeka Alfred Clement, Fresnel Lutèce Ontsi Obame, Laté Dzidoula Lawson, Romeo Bujiriri Murhega, Arsène Daniel Nyalundja, Nukunté David Lionel Togben
Egyptian Journal of Neurosurgery.2023;[Epub] CrossRef

A Successful Evacuation of Vertex Epidural Hematoma; A Case Report: Jang Hun Kim, Haewon Roh, Jong Hyun Kim, Taek Hyun Kwon; J Trauma Inj. 2017;30(3):98-102. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.98

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Abstract PDF: Vertex epidural hematoma (VEH) is an uncommon presentation of all epidural hematomas and presents with a wide range of symptom and signs. Diagnosis as well as treatment of VEH is also difficult because of its location adjacent to superior sagittal sinus (SSS). A 43-year-old male visited our hospital after fall down and was diagnosed with VEH. While evaluating its location and patency of SSS, he was deteriorated and urgently underwent evacuation of VEH. Bilateral craniotomies on each side, leaving a central bony island to avoid bleeding of midline structure and provide an anchor for dural tack-ups. After the operation, VEH was totally removed and the patient has restored.; Summary

Postoperative Contralateral Supra- and Infratentorial Acute Epidural Hematoma after Decompressive Surgery for an Acute Subdural Hematoma: A Case Report: Jeong Shik Lee, Cheol Su Jwa, Sook Young Sim, Gang Hyun Kim; J Korean Soc Traumatol. 2010;23(2):188-191.

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Abstract PDF: A postoperative contralateral supra- and infratentorial epidural hematoma after decompressive surgery is an extremely rare event. We describe a 38-year-old male with a contralateral supra- and infratentorial acute epidural hematoma just after decompressive surgery for an acute subdural hematoma. A contralateral skull fracture involving a lambdoidal suture and an intraoperative brain protrusion may be warning signs. The mechanisms, along with relevant literature, are discussed.; Summary

Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas: Young Hyun Cho, Jin Hoon Park, Ji Hoon Kim, Sung Woo Roh, Chang Jin Kim, Sang Ryong Jeon; J Korean Soc Traumatol. 2010;23(2):163-169.

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Abstract PDF: PURPOSE
Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH.
METHODS
We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively.
RESULTS
Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device.
CONCLUSION
Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.; Summary

Acute Traumatic intracranial Epidural Hematoma in a 4-month-old Infant after a Fall down: A Case Report: Sung Hwa Paeng; J Trauma Inj. 2012;25(4):275-277.

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Abstract PDF: An eipdural hematoma in an infant is a very rare entity. We report a case of an acute traumatic intracranial epidural hematoma that developed with a lucid interval in a 4-month-old infant after a fall down from a bed. The infant was admitted at the emergency room. The child had initially cried and may have had a decreased level of consciouseness due to brain injury, but then returned to normal level of consciousness for several hours prior to admission. However, the infant had vomited twice after taking milk and then was lethargic. The brain CT revealed a lentiform-shaped huge hematoma on the right parietal area with a midline shift of 8 mm. An osteoplastic craniotomy was performed, and the intracranial epidural hematoma was totally removed. Postoperatively, the infant recovered well and was dischaged.; Summary

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