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LETTER TO THE EDITOR |
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Year : 2013 | Volume
: 16
| Issue : 4 | Page : 179 |
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Bifrontal acute subdural hematoma
Suryapratap Singh
Department of Neurosurgery, NMCH, Chinthareddypalam, Nellore, Andhra Pradesh, India
Date of Web Publication | 21-Jan-2014 |
Correspondence Address: Suryapratap Singh Department of Neurosurgery, NMCH, Chinthareddypalam, Nellore - 524 002, Andhra Pradesh India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/1118-8561.125585
How to cite this article: Singh S. Bifrontal acute subdural hematoma. Sahel Med J 2013;16:179 |
Sir,
We appreciate the interest, comments and queries on our article "Bifrontal acute subdural hematoma" published in Sahel Med J Vol. 16; Issue 2 (April-June 2013). I admit the blurred image, which was because it was taken using a camera that had no high megapixel, but the image of sub dural haematoma (SDH) is very clear. The bilateral nature of the disease can very clearly be visualized on both slices of the pre-operative computed tomogram (CT) [Figure 1]. [1] Large volume bilateral hematoma are the ones that usually present as slit-like elongated ventricles ("squeezed ventricle," 'hare's ears sign hare's or "rabbit's ears"). [2],[3],[4],[5] with Our patient did not have large volume hematoma on either side. We also very clearly mentioned that hematoma was more on the right side [Figure 1].
Various literatures suggested that bifrontal craniotomy is indicated in bilateral frontal trauma with involvement of superior sagittal sinus as in the case presented. This is to achieve safe hemostasis, maintain intracranial pressure and remove hematoma completely. [6],[7],[8],[9]
We were fortunate that our patient achieved full recovery. This outcome may be related to the young age of our patient, quick surgical interventionand excellent on-table intra-operative decisions. The references related to chronic subdural hematoma were as relevant to the discussion regarding acute subdural hematoma. Both acute and chronic subdural hematoma present as mass effect in cranial cavity and they may share some clinical and radiological presentations. [10],[11]
References | | |
1. | Singh S, Mohammad A, Bedi S. Bifrontal acute subdural hematoma. Sahel Med J 2013;16:77-9. |
2. | Ellis GL. Subdural hematoma in the elderly. Emerg Med Clin North Am 1990;8:281-94. [PUBMED] |
3. | Karasawa H, Tomita S, Suzuki S. Chronic subdural hematomas. Time-density curve and iodine concentration in enhanced CT. Neuroradiology 1987;29:36-9. [PUBMED] |
4. | Kim KS, Hemmati M, Weinberg PE. Computed tomography in isodense subdural hematoma. Radiology 1978;128:71-4. [PUBMED] |
5. | Marcu H, Becker H. Computed-tomography of bilateral isodense chronic subdural hematomas. Neuroradiology 1977;14:81-3. |
6. | Miller JD, Bullock R, Graham DI, Chen MH, Teasdale GM. Ischemic brain damage in a model of acute subdural hematoma. Neurosurgery 1990;27:433-9. [PUBMED] |
7. | Ransohoff J, Benjamin MV, Gage EL Jr, Epstein F. Hemicraniectomy in the management of acute subdural hematoma. J Neurosurg 1971;34:70-6. [PUBMED] |
8. | Whitfield PC, Patel H, Hutchinson PJ, Czosnyka M, Parry D, Menon D, et al. Bifrontal decompressive craniectomy in the management of posttraumatic intracranial hypertension. Br J Neurosurg 2001;15:500-7. [PUBMED] |
9. | Zeilinger FS, Henzka O. The use of decompressive craniectomy for the management of severe head injuries. Brain Edema XI. Vienna: Springer; 2000. p. 475-8. |
10. | Adhiyaman V, Asghar M, Ganeshram KN, Bhowmick BK. Chronic subdural haematoma in the elderly. Postgrad Med J 2002;78:71-5. [PUBMED] |
11. | de Noronha RJ, Sharrack B, Hadjivassiliou M, Romanowski CA. Subdural haematoma: A potentially serious consequence of spontaneous intracranial hypotension. J Neurol Neurosurg Psychiatry 2003;74:752-5. [PUBMED] |
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