SUBDURAL FLUID ACCUMULATIONS FOLLOWING HEAD INJURY

Abstract

Subdural fluid accumulation after head injury seems to have escaped the comment of pathologists and surgeons. This pathologic condition is one found with or without fissured fracture of the skull, and has not been noted in association with depressed fractures or penetrating wounds. It is an accumulation of subdural but extra-arachnoid fluid. When a brain injury occurs, the immediate effects of damage are soon complicated by an increase in the fluid content within the skull. This fluid may be present as extravasated blood, as edema in which the fluid is more or less fixed in the swollen brain tissue, or as free fluid of other types. When present in considerable amounts, intracranial pressure results. For the surgeon, a practical pathologic classification includes three groups: (1) The extradural hemorrhages—chiefly of middle meningeal origin. (2) The swollen, contused and edematous brains, which in appearance vary from the small petechial hemorrhages to the