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[Chronic subdural hematoma and transient neurologic deficits]
F Nicoli1, L Milandre, P Lemarquis
1Service de Neurologie, Hôpital Sainte-Marguerite, Marseille.
Revue Neurologique
|January 1, 1990
Summary
Chronic subdural hematoma (CSDH) can mimic transient neurological accidents (TNA). Prompt diagnosis with CT scans is crucial for effective treatment and to rule out other serious conditions.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Chronic subdural hematoma (CSDH) is a known neurological condition.
- CSDH presenting as transient neurological accidents (TNA) is rare, accounting for 1-9% of CSDH cases.
Observation:
- Transient neurological symptoms like motor aphasia or speech interruption, especially in males over 60, may indicate CSDH.
- History of even minor head trauma and headache can be clues.
- Electroencephalography (EEG) showing delta activity over 48 hours post-TND warrants exclusion of TIA pending CT scan.
Findings:
- CSDH can manifest as TNA, mimicking transient ischemic attacks (TIA).
- The term transient neurological accident (TNA) is preferred over TIA when symptoms resolve within 24 hours, as causes can include hemorrhage or tumor.
- Emergency CT scans are vital for diagnosing CSDH and other potential causes of TNA.
Implications:
- Early diagnosis of CSDH through CT scans is essential for timely intervention.
- Finding a subdural hematoma should not halt investigations for concurrent cardiovascular issues.
- The underlying mechanism of TNA may involve vascular factors or epileptic activity, as suggested by cerebral SPECT findings.