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Minna Rauhala, Teemu M. Luoto, Heini Huhtala, Grant L. Iverson, Tero Niskakangas, Juha Öhman, and Pauli Helén

.916.71 3 Adhiyaman V , Chattopadhyay I , Irshad F , Curran D , Abraham S : Increasing incidence of chronic subdural haematoma in the elderly . QJM 110 : 375 – 378 , 2017 10.1093/qjmed/hcx143 28069915 4 Almenawer SA , Farrokhyar F , Hong C , Alhazzani W , Manoranjan B , Yarascavitch B , : Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients . Ann Surg 259 : 449 – 457 , 2014 24096761 10.1097/SLA.0000000000000255 5 Alves JL , Santiago JG , Costa G , Mota Pinto A : A standardized

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Panagiotis Kerezoudis, Anshit Goyal, Ross C. Puffer, Ian F. Parney, Fredric B. Meyer, and Mohamad Bydon

, geriatric patients experience worse mortality rates and functional outcomes than nonelderly TBI patients even though their head and overall injury burdens are seemingly less severe. 4 These patients also tend to have increased dependence postinjury given their decreased brain reserves. 5 Elderly patients are particularly prone to shearing of cortical bridging veins even in the setting of minor trauma, predisposing them to acute subdural hematomas (SDHs). The frequent use of antithrombotic agents in this population may further exacerbate the risk of complications and

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Neurosurgical Forum: Letters to the Editor To The Editor Allan J. Drapkin , M.D. University of Medicine and Dentistry of New Jersey Neptune, New Jersey 169 170 Abstract Object. The aim of this study was to determine the influence of closed-system subdural drainage on repeated operation rates after burr hole evacuation of subacute and chronic subdural hematomas (SDHs). Methods. Five hundred consecutive operations for the treatment of SDH via burr holes were performed between January 1, 1996, and April 15

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hematoma. Also, the authors did not obtain computerized tomography (CT) scans during the drainage period and therefore the small drainage volumes in the cases of recurrent hematomas may have been due to a malfunction in the drainage system. Reference 1. Fujisawa H , Nomura S , Tsuchida E , et al : Serum protein exudation in chronic subdural haematomas: a mechanism for haematoma enlargement? Acta Neurochir 140 : 161 – 166 , 1998 Fujisawa H, Nomura S, Tsuchida E, et al: Serum protein exudation in chronic subdural

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John W. Chambers

usually ascribe the origin of acute subdural haematomas to laceration of the veins crossing to the longitudinal sinus. One author has the following to say: “Acute subdural hematomas usually result from extensive laceration of the veins crossing to the sinus [? longitudinal]. As it is impossible to learn which of these many veins is involved it is impossible to control them and surgical treatment of this condition is rarely successful.” 3 Rowbotham 7 mentions as points of origin of the bleeding: lacerated dural venous sinus, cortical vein with associated tearing of

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Albert Zilkha and John M. Nicoletti

subagudo de la medúla espinal. An Cirug, Rosanio 18 : 117 – 123 , 1953 Albertengo JB: Hematoma subdural subagudo de la medúla espinal. An Cirug, Rosanio 18: 117–123, 1953 4. Anagnostopoulos DI , Gortvai P : Spontaneous spinal subdural haematoma. Br Med J 1 : 30 , 1972 Anagnostopoulos DI, Gortvai P: Spontaneous spinal subdural haematoma. Br Med J 1: 30, 1972 5. Carrea RME , Girado M , Eurnekian A : Hematoma crónico epidural y subdural espinal

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Chronic spinal subdural hematomas

Report of two cases

Virender K. Khosla, Vijay K. Kak, and Suresh N. Mathuriya

case report. Neurosurgery 2: 52–54, 1978 5. Brandt RA : Chronic spinal subdural haematoma. Surg Neurol 13 : 121 – 123 , 1980 Brandt RA: Chronic spinal subdural haematoma. Surg Neurol 13: 121–123, 1980 6. Brem SS , Hafler DA , Van Uitert RL , et al : Spinal subarachnoid hematoma. A hazard of lumbar puncture resulting in reversible paraplegia. N Engl J Med 304 : 1020 – 1021 , 1981 Brem SS, Hafler DA, Van Uitert RL, et al: Spinal subarachnoid hematoma. A hazard of lumbar puncture

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Unoperated subdural hematomas

Long-term follow-up study by brain scan and electroencephalography

John Lusins, Robert Jaffe, and Morris B. Bender

I t has been demonstrated that many cases of chronic and subacute subdural hematoma can be successfully treated nonsurgically. 1–4, 7, 9, 13 With increasing recognition of this fact, there has been a corresponding increase in the need for nonsurgical methods for the diagnosis and evaluation of this condition. Clinical-laboratory correlations must be studied in each case so that prognosis and management can be rationally determined. Radionuclide scanning and electroencephalography (EEG) are methods which can provide valuable information without risk to the

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Alan H. Fruin, Gregory L. Juhl, and Charles Taylon

, Evans JP : Aberrant location of subdural hematoma. Arch Neurol Psychiatry 44 : 1296 – 1306 , 1940 Aring CD, Evans JP: Aberrant location of subdural hematoma. Arch Neurol Psychiatry 44: 1296–1306, 1940 2. Clein LJ , Bolton CF : Interhemispheric subdural haematoma: a case report. J Neurol Neurosurg Psychiatry 32 : 389 – 392 , 1969 Clein LJ, Bolton CF: Interhemispheric subdural haematoma: a case report. J Neurol Neurosurg Psychiatry 32: 389–392, 1969 3. Echlin FA , Sordillo SVR

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Charles G. Drake

T he source of bleeding in subdural haematoma commonly is thought to be venous in origin, although there are well recognised exceptions to such a statement, such as the subdural clots associated with a ruptured aneurysm or those associated with contre-coup injury to the brain. Cases in which the bleeding arises from a single, small rent in a cortical artery are becoming recognised with increasing frequency. One hundred cases of subdural haematoma have been admitted to the Neurosurgical Service in London, Ontario; in 11 of these the bleeding definitely was