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http://dx.doi.org/10.3340/jkns.2013.54.1.38

Multiple Densities of the Chronic Subdural Hematoma in CT Scans  

Park, Hye-Ran (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
Lee, Kyeong-Seok (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
Shim, Jae-Jun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
Yoon, Seok-Mann (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
Bae, Hack-Gun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
Doh, Jae-Won (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.54, no.1, 2013 , pp. 38-41 More about this Journal
Abstract
Objective : Density of the chronic subdural hematoma (cSDH) is variable. It often appears to be mixed density. Multiple densities of cSDH may result from multiple episodes of trauma. We investigated the frequency of mixed density and the causes of head injuries representing each density. Methods : We could collect 242 cases of chronic SDH. The cSDHs were classified into four groups; hypodensity, homogeneous isodensity, layered type, and mixed type on the basis of CT scans. Results : The density of cSDH was isodense in 115 patients, hypodense in 31 patients, mixed in 79 cases, and layered in 17 cases. The cSDH was on the left side in 115 patients, on the right side in 70 patients, and bilateral in 40 patients. The history of trauma was identifiable in 122 patients. The etiology could be identified in 67.7% of the hypodense hematomas, while it was obscure in 59.5% of the mixed hematomas. Conclusion : Mixed density of cSDH results from multiple episodes of trauma, usually in the aged. It is hard to remember all the trivial traumas for the patients with the mixed density cSDHs. Although there were membranes within the mixed density hematomas, burr-holes were usually enough to drain the hematomas.
Keywords
Chronic subdural hematoma; Computed tomography; Craniocerebral trauma; Diagnosis;
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1 Stroobandt G, Fransen P, Thauvoy C, Menard E : Pathogenetic factors in chronic subdural haematoma and causes of recurrence after drainage. Acta Neurochir (Wien) 137 : 6-14, 1995   DOI
2 Sundstrom T, Helland CA, Aarhus M, Wester K : What is the pressure in chronic subdural hematomas? A prospective, population-based study. J Neurotrauma 29 : 137-142, 2012   DOI
3 Tsai FY, Huprich JE, Segall HD, Teal JS : The contrast-enhanced CT scan in the diagnosis of isodense subdural hematoma. J Neurosurg 50 : 64-69, 1979   DOI
4 Wilms G, Marchal G, Geusens E, Raaijmakers C, Van Calenbergh F, Goffin J, et al. : Isodense subdural haematomas on CT : MRI findings. Neuroradiology 34 : 497-499, 1992   DOI
5 Fujisawa H, Nomura S, Kajiwara K, Kato S, Fujii M, Suzuki M : Various magnetic resonance imaging patterns of chronic subdural hematomas : indicators of the pathogenesis? Neurol Med Chir (Tokyo) 46 : 333-338; discussion 338-339, 2006   DOI
6 Chon KH, Lee JM, Koh EJ, Choi HY : Independent predictors for recurrence of chronic subdural hematoma. Acta Neurochir (Wien) 154 : 1541-1548, 2012   DOI
7 Gelabert-González M, Iglesias-Pais M, García-Allut A, Martínez-Rumbo R : Chronic subdural haematoma : surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg 107 : 223-229, 2005   DOI
8 Kim BG, Lee KS, Shim JJ, Yoon SM, Doh JW, Bae HG : What determines the laterality of the chronic subdural hematoma? J Korean Neurosurg Soc 47 : 424-427, 2010   DOI
9 Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH : Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J Korean Neurosurg Soc 43 : 11-15, 2008   DOI
10 Kostanian V, Choi JC, Liker MA, Go JL, Zee CS : Computed tomographic characteristics of chronic subdural hematomas. Neurosurg Clin N Am 11 : 479-489, 2000
11 Lee KS, Bae WK, Bae HG, Doh JW, Yun IG : The computed tomographic attenuation and the age of subdural hematomas. J Korean Med Sci 12 : 353-359, 1997   DOI
12 Lee KS, Shim JJ, Yoon SM, Doh JW, Yun IG, Bae HG : Acute-on-chronic subdural hematoma : not uncommon events. J Korean Neurosurg Soc 50 : 512-516, 2011   DOI
13 Lee JY, Ebel H, Ernestus RI, Klug N : Various surgical treatments of chronic subdural hematoma and outcome in 172 patients : is membranectomy necessary? Surg Neurol 61 : 523-527; discussion 527-528, 2004   DOI
14 Lee KS : Natural history of chronic subdural haematoma. Brain Inj 18 : 351-358, 2004   DOI
15 Markwalder TM : Chronic subdural hematomas : a review. J Neurosurg 54 : 637-645, 1981   DOI
16 Mori K, Maeda M : Surgical treatment of chronic subdural hematoma in 500 consecutive cases : clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 41 : 371-381, 2001   DOI
17 Murakami H, Hirose Y, Sagoh M, Shimizu K, Kojima M, Gotoh K, et al. : Why do chronic subdural hematomas continue to grow slowly and not coagulate? Role of thrombomodulin in the mechanism. J Neurosurg 96 : 877-884, 2002   DOI
18 Santarius T, Hutchinson PJ : Chronic subdural haematoma : time to rationalize treatment? Br J Neurosurg 18 : 328-332, 2004   DOI
19 Sargent S, Kennedy JG, Kaplan JA : "Hyperacute" subdural hematoma : CT mimic of recurrent episodes of bleeding in the setting of child abuse. J Forensic Sci 41 : 314-316, 1996
20 Tanikawa M, Mase M, Yamada K, Yamashita N, Matsumoto T, Banno T, et al. : Surgical treatment of chronic subdural hematoma based on intrahematomal membrane structure on MRI. Acta Neurochir (Wien) 143 : 613-618; discussion 618-619, 2001   DOI
21 Senturk S, Guzel A, Bilici A, Takmaz I, Guzel E, Aluclu MU, et al. : CT and MR imaging of chronic subdural hematomas : a comparative study. Swiss Med Wkly 140 : 335-340, 2010