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[Hemorrhage into tha cavity of chronic subdural hematoma]

H Ito, T Shimoji, M Kimura

    No Shinkei Geka. Neurological Surgery
    |April 1, 1984
    PubMed

    Insights

    Daily hemorrhage into chronic subdural hematoma cavities averages 6.7% of volume, increasing with severity and decreasing over time post-trauma. This bleeding impacts clinical symptoms and CT scan density.

    Area of Science:

    • Neurosurgery
    • Pathophysiology
    • Radiology

    Context:

    • Chronic subdural hematoma (CSH) presents a significant clinical challenge.
    • Understanding the dynamics of hemorrhage within the hematoma cavity is crucial for patient management.
    • Previous studies have not fully elucidated the quantitative aspects of daily hemorrhage in CSH.

    Purpose:

    • To quantify the mean daily hemorrhage into the hematoma cavity in patients undergoing craniotomy for chronic subdural hematoma.
    • To investigate factors influencing daily hemorrhage, including patient demographics, time since trauma, clinical severity, and imaging findings.

    Summary:

    • Mean daily hemorrhage was 6.7% of hematoma volume, with variations across age groups.
    • Hemorrhage was higher within 3 months of trauma (25% >10% volume) and decreased significantly after 3 months (<2%).
    • Clinical severity correlated with increased hemorrhage, while dementia cases showed less bleeding. No clear correlation with CT/angiogram breadth was found.
    • Fibrin degradation product (FDP) levels between 320-640 µg/ml were associated with increased hemorrhage.
    • Hemorrhage results from a hyper-fibrinolytic and coagulability imbalance, impacting clinical status and CT density.

    Impact:

    • Provides quantitative data on daily hemorrhage in CSH, aiding in understanding disease progression.
    • Highlights the role of hemorrhage dynamics in CSH severity and radiological appearance.
    • Informs potential therapeutic strategies targeting fibrinolysis and coagulation in CSH management.

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