Clinicalcharacteristics and treatment of the traumatic interhemispheric subdural hematoma

Abstract

：Objective To analyzeretrospectively the clinical characteristics, pathogeny and therapy of traumaticinterhemispheric subdural hematoma (ISH). Methods 31 ISH cases admitted since 1996 werereviewed and analyzed retrospectively concerning the clinical characteristics andtherapies. Typically,ISH manifested itself with hemiplegia or monoplegia in thecontralateral lower limb, called the falx syndrome, and unconsciousness was infrequent atthe initial stage of the head injury. The pathogeny of ISH involved cracks of the bridgingvein, hematomas in the interhemispheric small arteries and veins and probably coagulationdysfunction or anticoagulant therapy. Results In all 31 patients, 29 were cured and 2 diedofmultisystem organ failure (MSOF) and cerebral hernia respectively. The follow-uprevealed that 6 cured patients developed interhemispheric subdural effusion. Conclusion CTscanning showing the interhemispheric hematoma exceeds 20 mL, or the interhemispherichematoma is thicker than 1 cm can be referential to the diagnosis of ISH. For the ISHtreatment, surgery and conservative management are suggested based on the functionaldisturbance or the stability of the disease. Patients with progressive neurologicdeterioration should be operated without delay. Key words: Craniocerebral trauma; Interhemispheric subdural; Hematoma; Therapy