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dc.contributor.authorZanini, Marco Antonio [UNESP]
dc.contributor.authorResende, Luiz Antonio de Lima [UNESP]
dc.contributor.authorFaleiros, Antonio Tadeu de Souza [UNESP]
dc.contributor.authorGabarra, Roberto Colichio [UNESP]
dc.date.accessioned2014-05-20T13:36:10Z
dc.date.available2014-05-20T13:36:10Z
dc.date.issued2008-03-01
dc.identifierhttp://dx.doi.org/10.1097/TA.0b013e3180485cfc
dc.identifier.citationJournal of Trauma-injury Infection and Critical Care. Philadelphia: Lippincott Williams & Wilkins, v. 64, n. 3, p. 705-713, 2008.
dc.identifier.issn0022-5282
dc.identifier.urihttp://hdl.handle.net/11449/12461
dc.description.abstractBackground: Traumatic subdural hygroma (TSHy) is an accumulation of cerebrospinal fluid (CSF) in the subdural space after head injury. It appears to be relatively common, but its onset time and natural history are not well defined. Considered a benign epiphenomenon of trauma, the pathogenesis of TSHy is still unclear and many questions remain unanswered. This study adds to the information on TSHy, and proposes a classification based on pathogenesis.Methods: Thirty-four consecutive adult patients with TSHy were analyzed for clinical evolution and serial CT scan, during a period of several months. TSHy diagnosis was based on published CT scan criteria of hypodense subdural collection after trauma, without enhancement and neomembrane, with a minimum distance of 3 mm between the skull and brain. Ventricle size was analyzed by calculating the bicaudate index (BCI). For comparison, the BCI was measured from CT scan at three moments: admission, at time of TSHy diagnosis, and from last CT scan.Results: There were 34 patients, aged between 16 and 85 years (mean 40), half of them were below 40 years. Road traffic crashes were the main cause of head injury. The mean time for hygroma diagnosis was 9 days. Twenty-one patients (61.8%) underwent conservative treatment for TSHy and 13 (38.2%), surgical treatment. TSHy are early lesions and can be detected in the first 24 hours after trauma, usually as small subdural effusion (SSEff). Based on clinical and CT scan findings, we divided the 34 patients into 3 groups, (Ia and Ib) without evident mass effect and (II) with evident mass effect. Group Ia includes patients without ventricle dilation; Ib, patients with associated ventricle dilations.Conclusions: SSEff detected in the first 24 hours posttrauma in our series evolved into TSHy suggesting that this is an early lesion; all THSy were divided in three groups according to the pathophysiologic mechanism. These three groups probably represent a continuum of CSF absorption impairment. Group la represents what most authors consider a simple hygroma, with no impairment on CSF absorption. Group Ib represent the external hydrocephalus form with various degrees of CSF imbalance, and group II were the cases presenting marked mass effect.en
dc.format.extent705-713
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofJournal of Trauma-injury Infection and Critical Care
dc.sourceWeb of Science
dc.subjectsubdural hygromaen
dc.subjectpathogenesisen
dc.subjecthead injuryen
dc.subjectexternal hydrocephalusen
dc.titleTraumatic subdural hygromas: Proposed pathogenesis based classificationen
dc.typeArtigo
dcterms.licensehttp://journals.lww.com/_layouts/oaks.journals/nih.aspx
dcterms.rightsHolderLippincott Williams & Wilkins
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.description.affiliationSão Paulo State Univ, Sch Med, Dept Neurol & Psychiat, Botucatu, SP, Brazil
dc.description.affiliationUnespSão Paulo State Univ, Sch Med, Dept Neurol & Psychiat, Botucatu, SP, Brazil
dc.identifier.doi10.1097/TA.0b013e3180485cfc
dc.identifier.wosWOS:000253996800029
dc.rights.accessRightsAcesso restrito
unesp.campusUniversidade Estadual Paulista (UNESP), Faculdade de Medicina, Botucatupt
dc.identifier.lattes2894975141895189
dc.identifier.lattes1346461670550428
dc.identifier.lattes6664825590096912
unesp.author.lattes2894975141895189]|
unesp.author.lattes1346461670550428]|
unesp.author.lattes6664825590096912]|
unesp.author.orcid0000-0002-5712-9783[1]
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