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LETTER TO THE EDITOR
Year : 2013  |  Volume : 16  |  Issue : 4  |  Page : 179

Bifrontal acute subdural hematoma


Department of Neurosurgery, NMCH, Chinthareddypalam, Nellore, Andhra Pradesh, India

Date of Web Publication21-Jan-2014

Correspondence Address:
Suryapratap Singh
Department of Neurosurgery, NMCH, Chinthareddypalam, Nellore - 524 002, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1118-8561.125585

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How to cite this article:
Singh S. Bifrontal acute subdural hematoma. Sahel Med J 2013;16:179

How to cite this URL:
Singh S. Bifrontal acute subdural hematoma. Sahel Med J [serial online] 2013 [cited 2024 Mar 28];16:179. Available from: https://www.smjonline.org/text.asp?2013/16/4/179/125585

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 Top

1.Singh S, Mohammad A, Bedi S. Bifrontal acute subdural hematoma. Sahel Med J 2013;16:77-9.  Back to cited text no. 1
  Medknow Journal  
2.Ellis GL. Subdural hematoma in the elderly. Emerg Med Clin North Am 1990;8:281-94.  Back to cited text no. 2
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3.Karasawa H, Tomita S, Suzuki S. Chronic subdural hematomas. Time-density curve and iodine concentration in enhanced CT. Neuroradiology 1987;29:36-9.  Back to cited text no. 3
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4.Kim KS, Hemmati M, Weinberg PE. Computed tomography in isodense subdural hematoma. Radiology 1978;128:71-4.  Back to cited text no. 4
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5.Marcu H, Becker H. Computed-tomography of bilateral isodense chronic subdural hematomas. Neuroradiology 1977;14:81-3.  Back to cited text no. 5
    
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.  Back to cited text no. 6
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7.Ransohoff J, Benjamin MV, Gage EL Jr, Epstein F. Hemicraniectomy in the management of acute subdural hematoma. J Neurosurg 1971;34:70-6.  Back to cited text no. 7
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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.  Back to cited text no. 8
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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.  Back to cited text no. 9
    
10.Adhiyaman V, Asghar M, Ganeshram KN, Bhowmick BK. Chronic subdural haematoma in the elderly. Postgrad Med J 2002;78:71-5.  Back to cited text no. 10
[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.  Back to cited text no. 11
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