Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2002
Diffuse brain injury complicated by acute subdural hematoma in the rodents: the effect of early or delayed surgical evacuation.
Of all the possible clinical factors affecting the outcome of patients suffering acute subdural hematomas (SDH), timing of surgical evacuation is certainly the most debated. The purpose of this study was to develop an experimental model able to reproduce the clinical behavior of post-traumatic SDH as observed in head injured patients. We present a novel model of SDH combined with diffuse brain injury (DBI), and investigate the effects of early and delayed surgical evacuation. ⋯ Physiological parameters were measured for 5 hours, followed by the assessment of brain water content. In this experimental model, there is strong evidence that trauma acts synergistically with SDH enhancing brain edema formation and increasing ICP. In absence of secondary insult, rapid evacuation of traumatic SDH limits exposure to high ICP, reduces brain edema and is beneficial.
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Acta Neurochir. Suppl. · Jan 2002
Diffuse brain injury complicated by acute subdural hematoma and secondary insults in the rodents: the effect of surgical evacuation.
Head Trauma associated with acute sudural hematoma (SDH) and complicated by secondary insult is a grave clinical combination with complex pathophysiology. The aim of this study was to develop a clinically relevant injury model, which can be used to study the interaction between injury mechanisms. We present a novel model of SDH combined with diffuse brain injury (DBI) and a hypoxic secondary insult, and investigate the effects of surgical evacuation. ⋯ Physiological parameters were measured for 5 hours, together with assessment of brain water content. Secondary insult after traumatic SDH was associated with significant brain swelling and stimulated refractory rise in ICP. In traumatic SDH complicated by secondary insult, brain swelling is exacerbated by surgical evacuation.