Post-Traumatic Subdural Hygroma: A One Year Follow up Case Report and Literature Review

Esteban Ortiz-Prado,Tamara Acosta Castillo,Mauricio Olmedo Lopez,Luis E Bermeo,Mario A Rubio

doi:10.5539/gjhs.v8n12p239

Abstract

<p>Post-traumatic subdural hygroma it is an intracranial lesion, commonly misdiagnosed due to its unclear symptomatology and slow progression. Defined as the presence of cerebral spinal fluid in between the arachnoid and the duramater layers; causing a variety of symptomatology that usually depend on the amount of fluid within this space (subdural). Post traumatic subdural hygroma it’s observed in 5-20% of all blunt head injuries, although its diagnosis it’s usually rare among emergency departments. Prognosis is usually good due to the absence of severe complications and its spontaneous resolution in mostly of the cases. We present a 26-year-old male patient, with history of high impact blunt trauma, presenting ocular refractive changes and headache. After CT scan evaluation and BOLD-MRI confirmation, a bilateral fronto-parietal subdural hygroma was confirmed.</p>

Highlights

Traumatic brain injuries (TBI) are a public health concern worldwide (Roozenbeek, Maas, & Menon, 2013)
We present a 26-year-old male patient, with history of high impact blunt trauma, presenting ocular refractive changes and headache
Mild brain injuries account for up to 75% to 95% of head traumas worldwide, severe brain injuries are correlated with worst prognosis and higher mortality (Bryant et al, 2010; Roozenbeek et al, 2011; Badri et al, 2012; Baum et al, n. d.; Røe et al, 2015)

Summary

Introduction

Traumatic brain injuries (TBI) are a public health concern worldwide (Roozenbeek, Maas, & Menon, 2013). High impact head traumas can cause open or closed injuries, skull fractures, epidural, subdural or intracranial hematomas, or less severe alterations such as concussions or post traumatic hygromas (McCrory et al, 2013; Ling, Hardy, & Zetterberg, 2015; Røe et al, 2015). PTSH are usually wrongly considered chronic subdural hematomas, especially after head trauma or Cerebrospinal fluid (CSF) accumulation or effusion (Wittschieber et al, 2015; Zanini et al, 2008) For these cases, the physiopathological mechanisms involved are the traumatically induced tears in the arachnoid membrane, rupture of a congenital arachnoid cyst or CSF leakage due to post inflammatory formation of neomembranes and new vessels (neovascularization) (Rajesh, Bramhaprasad, & Purohit, 2012; Kusuno et al, 1984; Stone et al, 1981). Evolution and prognosis in PTSH patients it’s usually favorable, being spontaneous, non surgical resolution the final treatment for most uncomplicated cases (Rajesh, Bramhaprasad, & Purohit, 2012; Wittschieber et al, 2015; Ki et al, 2015)

Case Report

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Discussion

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