Ziya Asan
Abstract
Introduction: A correlation cannot be established between clinical findings and hematoma thickness in Chronic Subdural Hematoma cases. The effects of hematoma on intracranial structures can be evaluated as a grading criterion. This study aims to establish a grading system by establishing a correlation ...
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Introduction: A correlation cannot be established between clinical findings and hematoma thickness in Chronic Subdural Hematoma cases. The effects of hematoma on intracranial structures can be evaluated as a grading criterion. This study aims to establish a grading system by establishing a correlation between the compression effects of hematoma and clinical conditions in Chronic Subdural Hematoma cases.Methods: The radiological and clinical findings of the cases diagnosed with Chronic Subdural Hematoma were recorded. Headache, dizziness, focal neurological deficit, and reduction in Glasgow Coma Scale scores were recorded as clinical criteria. Radiologically, a 4-grade grading system was prepared. Hematoma without compression effect, dural compression and sulcus effacement, parenchymal compression, and midline shift of more than 5 mm were used in the grading system, respectively. The clinical symptoms and signs within each grade were recorded.Results: Computed Tomography examinations and clinical findings of 414 cases were recorded. It has been noted that as the grade increases, the clinical symptoms and signs increase along with the increase in hematoma thickness. However, it has been noted that an absolute correlation cannot always be established between hematoma thickness and clinical symptoms.Conclusion: The grading system is instructive in showing the effects of hematoma on intracranial structures rather than hematoma thickness in Chronic Subdural Hematoma cases. Complete drainage of hematoma is rare in surgically treated cases. Clinical improvement is associated with optimal intracranial dynamics rather than hematoma thickness. The grading system is instructive regarding clinical and radiological follow-up of the cases.
Ziya Asan
Abstract
Introduction: The aim of the study was to evaluate the clinical and radiological follow-up of cases who had a history of spine trauma and were being followed up for a diagnosis of post-traumatic syringomyelia and to discuss the existing theories in the literature and the vortex effect in pathogenesis.Methods: ...
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Introduction: The aim of the study was to evaluate the clinical and radiological follow-up of cases who had a history of spine trauma and were being followed up for a diagnosis of post-traumatic syringomyelia and to discuss the existing theories in the literature and the vortex effect in pathogenesis.Methods: Records of 44 patients who had a history of high-energy spinal trauma and diagnosed post-traumatic syringomyelia after their follow-up were retrospectively evaluated. Cases were evaluated under two groups based on the type of trauma those affected by axial forces and those affected by vertical forces. Results from spinal MRI scans of the cases were recorded. Pathogenesis was aimed to be revealed by uncovering the relationship of trauma type with syringomyelia localization and size.Results: The mean age was 39.8; 26 cases were male, and 18 were female. 10 (58.8%) cases presented cervical, 4 (23.5%) cervicothoracic, and 3 (17.6%) thoracic syringomyelias due to axial trauma. 6 (22.2%) cases presented cervical, 4 (14.8%) cases cervicothoracic, and 17 (62.9%) thoracic syringomyelias due to vertical forces. Segmental asymmetries were frequently encountered among their neurological findings.Conclusion: Syringomyelias appeared most frequently in the cervical and cervicothoracic junction due to the vertebral column being affected by axial forces, whereas in the case of vertical forces, it appeared most frequently in the thoracic segments. When considered along with the mechanisms of syringomyelia development, the appearance of syringomyelias can be explained by a vortex effect inside the central canal.