A simple method of bedside twist-drill craniostomy and closed-system drainage for evacuation of chronic and subactue subdural hematoma is introduced. The principles and theoretical considerations that form the basis for this technique are discussed. The technique was used in 21 patients with chronic or subacute subdural hematoma; it has produced results superior to those of the conventional methods used in our patient population. Possible mechanism responsible for the better results with the simple twist-drill closed-system drainage are described.
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http://dx.doi.org/10.3171/jns.1977.46.2.0220 | DOI Listing |
Radiol Case Rep
March 2025
Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Calcified chronic subdural hematoma (CCSDH) is a rare condition characterized by the accumulation of calcified blood between the dura mater and arachnoid membrane, typically following remote trauma. These lesions often present as space-occupying, extra-axial masses over the cerebral convexity and can mimic extra-axial tumors, such as calcified meningiomas. A 73-year-old male with a history of prostate cancer, hypertension, and hyperlipidemia presented with vision changes and mild papilledema.
View Article and Find Full Text PDFNeurohospitalist
January 2025
Department of Neurology, Division of Neurocritical Care, University of North Carolina, Chapel Hill, NC, USA.
Background/objectives: There is currently no consensus regarding the optimal strategy for reversal of anticoagulation in life-threatening hemorrhage associated with factor XIa (FXIa) inhibitors.
Methods: For this clinical case report, informed consent was obtained from surrogate.
Results And Discussion: Here, we present the case of an 82-year-old female who sustained a large subdural hematoma after a fall.
Micrographia, characterised by small handwriting, is often linked to Parkinson's disease, but also resulted to injured brain lesions. The left-handed women in her 20s developed 'fast micrographia' after a traumatic brain injury from a traffic accident, showing bilateral subdural haematomas and frontal lobe contusions, but she had no paralysis and extrapyramidal symptoms. Neuropsychological tests showed reduced processing speed and memory deficits, aligning with frontal lobe damage.
View Article and Find Full Text PDFClin Neurol Neurosurg
January 2025
Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St Suite 3B, Boston, MA 02215, USA.
Background: The estimated incidence of chronic subdural hematomas (cSDH) in the general population is projected to nearly double over the next decade, likely making it the most commonly treated cranial neurosurgical condition in adults by 2030. We investigated the outcomes of middle meningeal artery embolization (MMAe) as either a primary or adjunctive treatment for cSDH in nonagenarian patients.
Methods: We retrospectively reviewed all patients 90 years of age or older treated with middle meningeal artery embolization for cSDH from 2018 to 2024 at two academic institutions.
J Neurol Surg Rep
January 2025
Department of Neurosurgery and Spine Surgery, Qatif Central Hospital, Qatif, Saudi Arabia.
A rare variant of congenital aqueductal stenosis (CAS) is known as adult-onset CAS, characterized by the emergence of symptoms during adulthood. A 35-year-old man presented complaining of acute-onset headache and vomiting. Magnetic resonance imaging of the brain revealed an acute hydrocephalus due to an aqueductal web.
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