SDH can happen in any age group, is mainly due to head trauma and CT scans are usually sufficient to make the diagnosis. Prognosis varies widely depending on the size and chronicity of the hemorrhage. Subdural hematomas, most frequently due to trauma, are seen in all age-groups although etiology will vary 4,5 :. Acute subdural hemorrhages usually present in the setting of head trauma. This is especially the case in young patients, where they commonly co-exist with cerebral contusions. Occasionally spontaneous acute subdural hematomas are seen with an underlying bleeding disorder e. A history of head trauma is often absent or very minor.
Dare to date: age estimation of subdural hematomas, literature, and case analysis
The timing of the breakdown of red blood cells and organization of hemorrhage has significance in the catabolism of heme and the processing of iron, but also has a practical application in terms of assigning, or attempting to assign, a time course with respect to traumatic events e. Attempts to date contusions, however, have generally been unsuccessful by macroscopic observation, whereas the microscopic observations provide broad data but are also anatomically imprecise as a function of time.
Intracranial lesions are of particular significance with respect to the timing of organizing hemorrhage given the acute, and often life-threatening nature of the hemorrhages, and the medicolegal investigation into potential crimes. Of concern is that the Prussian Blue reaction for iron, a relatively straightforward histochemical reaction that has been in use for over years, is sometimes suggested as a diagnostic test for chronicity.
as rehemorrhage; and two patients had CSF hygromas. Subdural hematomas evolved (in some cases the exact date of injury was unknown but a reasonable.
Microscopic study of the organization of the Subdural Haemorrhage SDH verified against the time period can help us in the determination of its age which has serious medico-legal implications. Very few studies concerning the dating of SDH are present in the literature. This study was conducted for dating the early subdural haemorrhage by routine histopathological stains. A prospective analytical study was conducted during July to December A total of cases 50 males and 50 females fulfilling the inclusion and exclusion criteria were included in this study.
Routine histopathological staining of the subdural haematoma was done. Correlation between the frequency of a given histomorphological phenomenon and the length of the Post-Traumatic Interval PTI was evidential. All the histomorphological features, when correlated with PTI groups, were found to be statistically significant, except for Polymorphonuclear Leukocytes PMN.
We concluded that routine histopathology was reliable in the dating of early subdural haemorrhages. Road traffic accidents take about 1. One more fact to be noticed is that deaths due to head trauma outnumber the deaths caused due to injury to any other region [ 5 ]. Acute Subdural Haematoma SDH is the collection of blood between the dural and the arachnoid layers of the meninges. It is one of the most common types of intracranial mass lesion associated with high mortality and morbidity. The continuously altering nature of the SDH has often put the forensic community in a disadvantageous position about its duration and if improperly interpreted may lead to legal catastrophes in the fact that an innocent may be found guilty and a culprit vice versa.
Dating subdural hematomas. Journal of admission was used to accurately date sdhs. We aimed to do so, poisoning; accepted date: september 07, try the brain beneath its outer covering. When blood cells of the subdural hemorrhages. Subdural hematomas and find a common variant of the brain.
Hobbs et al report an incidence of subdural haematoma/effusion in infancy from all of age (and per aged 0–2) in the largest UK study to date.
A chronic subdural hematoma is an “old” collection of blood and blood breakdown products between the surface of the brain and its outermost covering the dura. The chronic phase of a subdural hematoma begins several weeks after the first bleeding. A subdural hematoma develops when bridging veins tear and leak blood. These are the tiny veins that run between the dura and surface of the brain.
This is usually the result of a head injury. A collection of blood then forms over the surface of the brain. In a chronic subdural collection, blood leaks from the veins slowly over time, or a fast hemorrhage is left to clear up on its own. A subdural hematoma is more common in older adults because of normal brain shrinkage that occurs with aging. This shrinkage stretches and weakens the bridging veins. These veins are more likely to break in older adults, even after a minor head injury. You or your family may not remember any injury that could explain it.
Dating of Early Subdural Haematoma: A Correlative Clinico-Radiological Study
A subdural hematoma is a serious, and potentially life-threatening, head injury that occurs when blood collects between the brain’s cover known as the dura and its surface. A subdural hematoma is not something you can diagnose at home, though you may suspect you have one based on symptoms. Any head injury is a medical emergency that has the potential to become life-threatening. So if you have recently suffered a blow to the head, have signs of a stroke, or have experienced a change in consciousness or personality, don’t delay seeking medical help.
Prompt medical assistance is the single best predictor of recovery from any head injury, including subdural hematomas.
However, to date, several studies have shown discordances about SDH-associated seizures Search terms included subdural haematoma, seizure, epilepsy.
Chronic subdural hematoma CSDH is prevalent among elderly populations worldwide, and its mysterious pathogenesis has been discussed in the literature for decades. The issues remaining to be solved in regard to CSDH include the initiating events; the bleeding into the subdural space and the formation of the outer and inner membranes, its development; increase and liquefaction of hematoma, the optimal treatments, and the natural history.
The pathophysiology is becoming more clear due to recent findings from computed tomography studies and human models of CSDH. In this work, we review previous studies on CSDH and present a new integrated concept about the development of this common condition after head injuries. Already have an account? Login in here. Journal of Medical and Dental Sciences. Journal home Journal issue About the journal. Keywords: subdural fluid collection , chronic subdural hematoma , inflammation , neomembrane , head injury , craniotomy , unruptured cerebral aneurysms.
Article overview. References
Study record managers: refer to the Data Element Definitions if submitting registration or results information. Chronic subdural hematoma CSDH is a neurological disease characterized by a collection of fluid, blood, and blood degradation matter between the arachnoid and dura mater in a well-developed membrane cavity. The presentation of this disease begins with minor head trauma and takes weeks to become symptomatic.
Dating of Early Subdural Haematoma: A Correlative Clinico-Radiological Study. Murali Gundu Rao, Dalbir Singh, [ ], and Suresh Kumar.
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Chronic subdural hematoma
Determination of post-traumatic interval remains one of the foremost important goals of any forensic investigation related to human crimes. The estimation of time since injury in cases of subdural haemorrhage has been studied only by a few investigators on the histological and radiological front. The study included a total of cases of closed head injury with subdural haemorrhage.
Statistically significant results were obtained between the HU measurements of the SDH and the post-traumatic intervals and were found to be statistically significant. A rough attempt was made to determine the effect of haematoma volume on attenuation and was found out to be statistically insignificant.
I have found that CT and MRI findings are complementary when it comes to tackling the dating of an injury and characterization of intracranial hemorrhage.
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: The age estimation of injuries, e. Based on the cumulative data from the two published… Expand Abstract. View on Springer. Save to Library. Create Alert. Launch Research Feed. Share This Paper.
Top 3 of 9 Citations View All Histological dating of subdural hematoma in infants. Delteil, S. Alison Krywanczyk, Elizabeth A. Bundock Journal of forensic sciences