Traumatic subdural effusion

Introduction to traumatic subdural effusion Traumatic subdural effusion refers to the formation of a large amount of fluid retention in the subdural space after trauma, also known as traumatic subdural hydroma. Because of brain damage, the brain tissue moves strongly in the cranial cavity, causing the arachnoid membrane to be torn, and the cerebrospinal fluid flows through the hiatus to the subdural space between the subdural and the arachnoid. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: coma

Traumatic subdural effusion

Trauma factors (35%):

It is generally believed that when the head is traumatized, the brain moves in the skull, causing the arachnoid membrane on the cerebral cistern or brain surface to rupture and forming a flap. It is usually 50-60ml, and more than 100ml, which is clinically divided according to the symptoms. For acute, subacute and chronic three types.

Disease factors (65%):

Because the arachnoid rupture is like a one-way valve, the cerebrospinal fluid can continuously flow out with the patient's struggle, breath holding, coughing, etc., and the cerebrospinal fluid enters the subdural space and cannot flow back, gradually forming a tension liquid retention, covering the amount , top, sputum surface, causing the performance of brain tissue compression, the liquid in the acute phase is mostly bloody, that is, subarachnoid hemorrhage, blood cerebrospinal fluid into the subdural cavity, subacute is yellow liquid, chronic is mostly grass yellow Or colorless transparent liquid, the protein content of the general subdural effusion is higher than normal cerebrospinal fluid, but lower than the hematoma fluid.

Traumatic subdural effusion prevention

In patients with subdural effusion, primary brain injury is generally mild. If the treatment is timely and reasonable, the effect is good. If the primary brain injury is severe and/or accompanied by intracranial hematoma, the prognosis is poor, and the mortality rate can be Up to 9.7% to 12.5%

1. Prevention of brain damage: The drainage tube should be strictly biased toward the direction of the dura mater. Do not attach the brain tissue to avoid damage to the brain tissue during intubation or extubation.

2, after surgery should pay attention to add isotonic fluid, drainage tube elevation 15cm, maintain normal intracranial pressure, if necessary, take a supine or head low position, is conducive to brain tissue reduction.

Traumatic subdural effusion complications Complications coma

The main complication of traumatic subdural effusion is that the primary brain injury is generally mild, mainly characterized by elevated intracranial pressure and localized signs of brain compression. The progression of the disease is slower than the subdural hematoma. Chronic and chronic subdural hematoma symptoms are similar, insidious onset, often not noticed, until the symptoms of increased intracranial pressure, mental disorders and signs of brain compression. In severe cases, cerebral palsy, such as coma, dilated pupils, and brain rigidity.

Traumatic subdural effusion symptoms common symptoms nausea and vomiting coma mental disorder increased intracranial pressure cerebral palsy to brain rigidity

The performance of acute subdural effusion is similar to that of acute and subacute subdural hematoma, but the primary brain injury is generally mild, mainly characterized by elevated intracranial pressure and localized signs of brain compression. Subdural hematoma is slow, chronic symptoms are similar to chronic subdural hematoma. Insidious onset is often not noticed until symptoms of increased intracranial pressure, mental disorders and signs of brain compression are present, and coma occurs in severe cases. , dilated pupils, go to the brain and other symptoms of cerebral palsy.

The clinical features are light or moderate closed head injury. The primary brain injury is often mild. After the injury, there is a progressive increase in headache, vomiting and optic disc edema. The development of the disease is mostly subacute or chronic, occasionally. It can be an acute process. In severe cases, the temporal lobe can be hooked back. About 30.4% of patients have unilateral dilated pupils. About half of them are consciously progressive and positive for pyramidal tract. The amount of subdural fluid is generally 50 ~ 60ml, more than 150ml, its traits, acute are mostly blood cerebrospinal fluid, a little longer turned yellow clear liquid, protein content is slightly higher than normal.

Traumatic subdural effusion examination

1. CT scan: showing a crescent-shaped low-density shadow, CT value of about 7Hu, close to the density of cerebrospinal fluid, the placeholder performance is lighter than the subdural hematoma, subdural effusion can develop into a subdural hematoma, possibly re Due to bleeding, the CT value can be increased.

2. MRI: Regardless of acute or chronic subdural effusion, there is a crescent-shaped T1 and long T2 signal on MRI, and the signal intensity is close to cerebrospinal fluid.

Diagnosis and diagnosis of traumatic subdural effusion

According to the increase of intracranial pressure and the signs of brain compression and the characteristic features of brain CT scan or MRI after mild head trauma, general positioning and qualitative diagnosis can be made.

The clinical manifestations of subdural effusion resemble subdural hematoma. There are also acute, subacute and chronic points. Some cases have high cystic protein content or hemorrhage, CT and MRI are not typical, and subdural hematoma. It is difficult to distinguish before surgery, but the signal on the MRI image is close to the cerebrospinal fluid, and the hematoma signal is strong, especially in the T-weighted image, the hematoma is high-intensity signal, which can be identified.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.