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Pure subdural haematomas of arteriolar origin
M Borzone1, M Altomonte, M Baldini
1Institute of Clinical Neurosurgery, University of Genoa, Italy.
Acta Neurochirurgica
|January 1, 1993
Summary
Subdural hematomas (SDHs) from ruptured cortical arterioles are rare, often affecting elderly patients with severe symptoms. Prompt surgery is crucial for these spontaneous or trauma-related cases, despite high mortality risks.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Subdural hematomas (SDHs) of arteriolar origin are rare neurosurgical conditions.
- They typically arise from ruptured cortical arteriolar branches, often near the Sylvian fissure.
Purpose of the Study:
- To report on 15 consecutive cases of arteriolar origin SDHs.
- To discuss clinical features, neuroradiological aspects, and treatment outcomes.
Main Methods:
- Retrospective review of 15 patients operated on over 20 years.
- Analysis of clinical presentation, CT scans, and surgical outcomes.
Main Results:
- SDHs were pure, without parenchymal lesions, and spontaneous in 40% of cases.
- Elderly patients (60% with GCS < 8) presented with severe clinical conditions.
- Mortality rate exceeded 50%, primarily linked to pre-operative Glasgow Coma Scale (GCS) scores.
Conclusions:
- Prompt surgical intervention is vital for arteriolar SDHs, irrespective of CT findings.
- Early treatment is essential to prevent neurological deterioration and improve outcomes.
- High mortality underscores the severity and need for timely management.