• Klíčová slova
• ELECTROENCEPHALOGRAPHY *, HEMATOMA, SUBDURAL *,
• MeSH
• elektroencefalografie * MeSH
• hematom * MeSH
• lidé MeSH
• subdurální hematom * MeSH
• subdurální prostor * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Chronic subdural hematoma (ChSDH) is, by definition, a subdural collection of blood older than 21 days. It is not exceptional that ChSDH is diagnosed in regional hospitals and thus we believe that basic knowledge on this topic is relevant for every general surgeon. Below, we summarize information on ChSDH and present simple clinical management guidelines. TREATMENT: In asymptomatic patients with ChSDH, monitoring alone may be sufficient. Subdural collections of only a few millimeters are a relatively common incidental finding on graphical examination of the brain, especially in the elderly with brain atrophy. In symptomatic patients, surgical treatment is justified. As a first step, burr hole evacuation of the hematoma in local anesthesia is performed. It is a simple, well-tolerated procedure and advantageous in elderly polymorbid patients. In symptomatic patients with recurrent ChSDH, reoperation using either the same burr hole or a new one is indicated. Patients with multilobulated hematomas that recur after the burr hole are scheduled for a craniotomy. CONCLUSION: ChSDH is a common condition encountered by all general surgeons during their clinical practice. The most common clinical presentations of ChSDH are headache, confusion, hemiparesis and aphasia. Asymptomatic patients may be followed by watchful waiting, whereas symptomatic patients are indicated for surgical treatment. All patients with ChSDH should be referred to a neurosurgical department (preferably a certified level 1 trauma center) with experience in neurotrauma care.

• Klíčová slova
• neurosurgery - head trauma - chronic subdural hematoma - burr hole -craniotomy.,
• MeSH
• chronický subdurální hematom * diagnóza   chirurgie   MeSH
• drenáž MeSH
• kraniotomie * MeSH
• lidé MeSH
• recidiva MeSH
• reoperace MeSH
• senioři MeSH
• trepanace * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Spinal subdural hematoma is a rare and potentionally life-threatening condition associated with trauma and other pathological conditions. In this paper we report the autopsy findings of a 64 year old male who was repeatedly hospitalized with traumatic head injuries in the past. In this case spinal subdural hematoma was diagnosed post-mortem and later comfirmed by ante-mortem CT scan revaluation. Keywords: intracranial subdural hematoma - recurrent spinal subdural hematoma - diffuse axonal injury - autopsy findings.

• MeSH
• lidé MeSH
• senioři MeSH
• subdurální hematom * komplikace   diagnóza   MeSH
• subdurální prostor * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Chronic calcified/ossified subdural hematoma is a rare diagnosis. The incidence of chronic calcified subdural hematoma is 0.3-2.7% of all chronic subdural hematomas. Surgical treatment is indicated in most cases, but there is still some controversy. MATERIALS AND METHODS: We present a case report of 81-year-old woman with calcified chronic subdural hematoma. Patient underwent an osteoplastic left craniotomy, evacuation of chronic subdural mass with careful dissection andsuccessful removal of inner and outer membrane. Postoperative CT scan showed removal of subdural hematoma, decrease of left shift of median line and good brain re-expansion. Postoperative period was without any serious complications. RESULTS: Subdural hematoma was successfully removed, resulting in a good recovery with complete resolution of patients symptoms. From our experience, we highly recommend surgical treatment in cases of chronic symptomatic calcified subdural hematomas.

• Klíčová slova
• calcified, ossified, subdural hematoma, surgical treatment,
• MeSH
• chronický subdurální hematom diagnostické zobrazování   chirurgie   MeSH
• kalcinóza diagnostické zobrazování   chirurgie   MeSH
• kraniotomie MeSH
• lidé MeSH
• počítačová rentgenová tomografie MeSH
• senioři nad 80 let MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

STUDY AIM: The primary aim is to analyze the relationship between the reasons for reoperation after surgery for acute subdural hematoma and the injury mechanism and secondarily the relationship between the acute subdural hematoma primarily operated on and the area of reoperation. METHODS: Among adult patients operated on for acute subdural hematoma between 2013 and 2017, patients reoperated within 14 days were identified. Injury mechanisms, reasons for reoperation, and reoperated lesion location were studied. RESULTS: Of 86 patients operated on for acute subdural hematoma, 24 patients were reoperated (27.9%). The main indications for reoperation after uncomplicated falls as injury cause (12 patients) were recurrent/significant residual subdural hematoma (7 patients) and contralateral subdural hematoma (3 cases). In complicated falls (long staircase, 3 patients), the reasons for reoperation were expansive intraparenchymal hematoma or brain contusion. In traffic accidents (4 patients, 3 pedestrians hit by cars), the reason for reoperations was brain contusion (two cases), contralateral intracerebral and subdural hematoma and postoperative epidural hematoma. Injury mechanism was unknown in 5 patients. In 20.8% of reoperations, the reoperated lesion (mainly subdural hematoma) was contralateral to the primary subdural hematoma. Prognosis was worse in reoperated patients. CONCLUSIONS: Recurrent/significant residual subdural hematomas are the most frequent reasons for reoperation after acute subdural hematoma surgery. The reasons for reoperations are related to the mechanism of injury. Simple falls are associated mainly with recurrent/significant residual or contralateral subdural hematomas. In complicated falls or traffic accidents (vigorous injuring force) hemorrhagic injuries of the brain parenchyma prevail.

• Klíčová slova
• Acute subdural hematoma, Brain contusion, Brain injury mechanism, Contralateral subdural hematoma, Reoperation,
• MeSH
• akutní subdurální hematom etiologie   chirurgie   MeSH
• dospělí MeSH
• epidurální hematom chirurgie   MeSH
• lidé MeSH
• počítačová rentgenová tomografie MeSH
• reoperace škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

• Klíčová slova
• CEREBRAL HEMORRHAGE *,
• MeSH
• cerebrální krvácení * MeSH
• lidé MeSH
• subdurální hematom * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dítě MeSH
• intrakraniální tlak MeSH
• kojenec MeSH
• lidé MeSH
• lymfangiom terapie   MeSH
• nádory mozku terapie   MeSH
• následné studie MeSH
• předškolní dítě MeSH
• shunty pro odvod mozkomíšního moku MeSH
• subdurální hematom terapie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• HEMATOMA, SUBDURAL *,
• MeSH
• hematom * MeSH
• lidé MeSH
• subdurální hematom * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To analyze the reasons and patient-related and injury-related risk factors for reoperation after surgery for acute subdural hematoma (SDH) and the effects of reoperation on treatment outcome. METHODS: Among adult patients operated on for acute SDH between 2013 and 2017, patients reoperated within 14 days after the primary surgery were identified. In all patients, parameters were identified that related to the patient (age, anticoagulation, antiplatelet, and antiepileptic treatment, and alcohol intoxication), trauma (Glasgow Coma Score, SDH thickness, midline shift, midline shift /hematoma thickness rate, other surgical lesion, primary surgery-trephination, craniotomy, or decompressive craniotomy), and Glasgow Outcome Score (GOS). The reasons for reoperation and intervals between primary surgery and reoperation were studied. RESULTS: Of 86 investigated patients, 24 patients were reoperated (27.9%), with a median interval of 2 days between primary surgery and reoperation. No significant differences in patients and injury-related factors were found between reoperated and non-reoperated patients. The rate of primary craniectomies was higher in non-reoperated patients (P = 0.066). The main indications for reoperation were recurrent /significant residual SDH (10 patients), contralateral SDH (5 patients), and expansive intracerebral hematoma or contusion (5 patients). The final median GOS was 3 in non-reoperated and 1.5 in reoperated patients, with good outcomes in 41.2% of non-reoperated and 16.7% of reoperated patients. CONCLUSIONS: Reoperation after acute SDH surgery is associated with a significantly worse prognosis. Recurrent /significant residual SDH and contralateral SDH are the most frequently found reasons for reoperation. None of the analyzed parameters were significant reoperation predictors.

• Klíčová slova
• Acute subdural hematoma, Brain injury, Contralateral subdural hematoma, Decompressive craniectomy, Reoperation,
• MeSH
• akutní subdurální hematom epidemiologie   etiologie   chirurgie   MeSH
• antikoagulancia terapeutické užití   MeSH
• antikonvulziva terapeutické užití   MeSH
• dekompresní kraniektomie statistika a číselné údaje   MeSH
• dospělí MeSH
• epilepsie farmakoterapie   epidemiologie   MeSH
• Glasgowská stupnice kómat MeSH
• Glasgowská stupnice následků MeSH
• inhibitory agregace trombocytů terapeutické užití   MeSH
• kraniocerebrální traumata komplikace   MeSH
• kraniotomie statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurochirurgické výkony statistika a číselné údaje   MeSH
• otrava alkoholem epidemiologie   MeSH
• reoperace statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• trepanace statistika a číselné údaje   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antikoagulancia MeSH
• antikonvulziva MeSH
• inhibitory agregace trombocytů MeSH

OBJECTIVE: This report illustrates the rare rapid spontaneous redistribution of an acute intracranial supratentorial subdural hematoma (AISSDH) to the entire spinal subdural space (SSS). The study is also unique in that the spinal subdural hematoma (SSH) manifested by the extremely rare Pourfour du Petit Syndrome (PPS). METHODS: A 66-year-old man sustained blunt head trauma. On admission to the regional hospital, he scored 6 on GCS and his pupils were of equal size reacting to light. Initial computed tomography (CT) scan showed a unilateral AISSDH. The patient was referred to our department and arrived 16 h following the accident, at which time a repeat CT scan revealed almost complete resolution of the AISSDH without clinical improvement. On the 9th postinjury day transient anisocoria and tachycardia without spinal symptomatology developed. Since neither neurological examination nor follow-up CT scans showed intracranial pathology explaining the anisocoria, the patient was treated further conservatively. During the next 3 days circulatory instability developed and the patient succumbed to primary traumatic injury. Autopsy revealed a SSH occupying the entire SSS. CONCLUSION: This case calls attention to the unique combination of the displacement of an AISSDH to the SSS and the presentation of this clinical entity by the PPS.

• MeSH
• akutní subdurální hematom komplikace   diagnóza   patologie   MeSH
• anizokorie etiologie   MeSH
• fatální výsledek MeSH
• kraniocerebrální traumata komplikace   patologie   MeSH
• lidé MeSH
• počítačová rentgenová tomografie MeSH
• senioři MeSH
• spinální subdurální hematom komplikace   MeSH
• spontánní remise MeSH
• subdurální prostor patologie   MeSH
• syndrom MeSH
• tachykardie komplikace   MeSH
• tupá poranění komplikace   patologie   MeSH
• úrazy a nehody MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH