Skip to main content

Traumatic Intracranial Hematomas: Pathophysiological Aspects on Their Course and Treatment

  • Chapter
  • 103 Accesses

Part of the book series: Acta Neurochirurgica ((NEUROCHIRURGICA,volume 36))

Summary

Hematomas in head injuries as a general rule reach their definite size within minutes after the trauma, the bleeding being effectively checked by an interaction of an increased intracranial pressure and the natural hemostatic processes. In epidural hemorrhage the development of arteriovenous shunting in the epidural space may result in continuing bleeding. In special circumstances vascular injury may produce delayed hemorrhage related to increased transmural pressure in the vascular bed and the development of a hyperfibrinolysis syndrome. The clinical effect of a hematoma is quantitatively related to its volume, but modified to a considerable degree in the particular case by the size of the extraaxial space and the arterial blood pressure. Some implications for treatment are commented upon.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Aronson SM, Okazaki H (1963) A study of some factors modifying response of cerebral tissue to subdural hematoma. J Neurosurg 20: 89–93

    Article  PubMed  CAS  Google Scholar 

  2. Ericsson K, Hâkansson S, Löfgren J, Zwetnow NN (1979) Extravasation and arteriovenous shunting after epidural bleeding. A radiological study. Neuroradiology 17: 239–244

    Google Scholar 

  3. Fogelholm R, Heiskanen O, Waltimo O (1975) Chronic subdural hematoma in adults. Influence of patient’s age on symptoms signs and thickness of hematoma. J Neurosurg 42: 43–47

    Google Scholar 

  4. Fukamachi A, Nagasaki Y, Kohno K, Wakao T (1985) The incidence and developmental process of delayed traumatic intracerebral hematomas. Acta Neurochir (Wien) 74: 35–39

    Article  CAS  Google Scholar 

  5. Gennarelli TA, Thibault LE (1982) Biomechanics of acute subdural hematoma. J Trauma 22: 680–685

    Article  PubMed  CAS  Google Scholar 

  6. Greenberg J, Coken WA, Cooper PR (1985) The “hyperacute” extraaxial intracranial hematoma: Computed tomographic findings and clinical insignificance. Neurosurgery 17: 48–56

    Google Scholar 

  7. Habash AH, Zwetnow NN, Ericson K, Löfgren J (1983) Arteriovenous epidural shunting in epidural bleeding.Radiological and physiological characteristics. An experimental study in dogs. Acta Neurochir (Wien) 67: 291–313

    Google Scholar 

  8. Ito H, Komai T, Yamamoto S (1978) Fibrinolytic enzyme in the lining walls of chronic subdural hematoma. J Neurosurg 48: 197200

    Google Scholar 

  9. Ito H, Yamamoto S, Komai T, Mizukoshi H (1976) Role of local hyperfibrinolysis in the etiology of chronic subdural hematoma. J Neurosurg 45: 26–31

    Article  PubMed  CAS  Google Scholar 

  10. Kaufman HH, Moake JL Olson JD, et al. (1980) Delayed and recurrent intracranial hematomas related to disseminated intra-vascular clotting and fibrinolysis in head injury. Neurosurgery 7: 445–449

    Article  PubMed  CAS  Google Scholar 

  11. Loew F, Wüstner S (1960) Diagnose, Behandlung and Prognose der traumatischen Hämatome des Schädelinneren. Acta Neurochir (Wien) [Suppl] V III, Wien, Springer

    Google Scholar 

  12. Loew F, Kivelitz R (1976) Chronic subdural hematomas. In: Vinken PJ, Bruyns GW (ed) Handbook of clinical neurology, vol 24, part I I. North-Holland Publ Co, Amsterdam Oxford and American Elsevier Publ Co New York

    Google Scholar 

  13. Loew F (1982) Management of chronic subdural hematomas and hygromas. In: Krayenbühl H et al. (ed) Advances and technical standards in neurosurgery. Springer, Wien New York

    Google Scholar 

  14. Löfgren J, Zwetnow NN (1972) Kinetics of arterial and venous hemorrhage in the skull cavity. In: Brock M, Dietz H (eds) Intracranial pressure, experimental and clinical aspects. Springer, Berlin Heidelberg New York, pp 155–159

    Google Scholar 

  15. Markwalder TM, Seiler RW (1985) Chronic subdural hematomas: to drain or not to drain? Neurosurgery 16: 185–188

    Article  PubMed  CAS  Google Scholar 

  16. Schrader H, Löfgren J, Zwetnow NN (1985) Influence of blood pressure on tolerance to an expanding mass. Acta Neurol Scand 71: 114–126

    Article  PubMed  CAS  Google Scholar 

  17. Seelig JM, Becker DP, Miller JD, Greenberg RP, Ward JD, Chois SC (1981) Traumatic acute subdural hematoma. New Engl J Med 304: 1511–1518

    Article  PubMed  CAS  Google Scholar 

  18. Shenkin HA (1982) Acute subdural hematoma. J Neurosurg 57: 254–257

    Article  PubMed  CAS  Google Scholar 

  19. Steiner L, Bergvall V, Zwetnow NN (1975) Quantitative estimation of intracerebral and intraventricular hematoma by computer tomography. Acta Radiol (Stockh) [Suppl] 346: 143154

    Google Scholar 

  20. Steiner L, Löfgren J, Zwetnow NN (1975) Characteristics and limits of tolerance in repeated subarachnoid hemorrhage in dogs. Acta Neurol Scand 52: 241–267

    Article  PubMed  CAS  Google Scholar 

  21. Steiner L, Löfgren J, Zwetnow NN (1975) Lethal mechanism in repeated subarachnoid hemorrhage in dogs. Acta Neurol Scand 52: 268–293

    Article  PubMed  CAS  Google Scholar 

  22. Zimmerman RA, Bilaniuk LT (1982) Computed tomographic staging of traumatic epidural bleeding. Radiology 144: 809–812

    PubMed  CAS  Google Scholar 

  23. Zwetnow NN, Habash AH, Löfgren J, Hâkansson S (1983) Comparative analysis of experimental epidural and subarachnoid bleedings in dogs. Acta Neurochir (Wien) 67: 67–101

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1986 Springer-Verlag

About this chapter

Cite this chapter

Löfgren, J. (1986). Traumatic Intracranial Hematomas: Pathophysiological Aspects on Their Course and Treatment. In: Lindgren, S. (eds) Modern Concepts in Neurotraumatology. Acta Neurochirurgica, vol 36. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8859-0_43

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-8859-0_43

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-81931-9

  • Online ISBN: 978-3-7091-8859-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics