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Infants, too, have larger subdural spaces and are more predisposed to subdural bleeds than are young adults. [3] It is often claimed that subdural hematoma is a common finding in shaken baby syndrome, although there is no science to support this. [8] In juveniles, an arachnoid cyst is a risk factor for subdural hematoma. [12]
Subdural hemorrhage (SDH) results from tearing of the bridging veins in the subdural space between the dura and arachnoid mater. It can cross the suture lines, but not across dural reflections such as falx cerebri or tentorium cerebelli. [4] Therefore, subdural hematoma always limited to one side of the brain. [3]
Subdural hygromas require two conditions in order to occur. First, there must be a separation in the layers of the Meninges of the brain. Second, the resulting subdural space that occurs from the separation of layers must remain uncompressed in order for CSF to accumulate in the subdural space, resulting in the hygroma. [1]
Hemorrhage into the basal ganglia or thalamus causes contralateral hemiplegia due to damage to the internal capsule. [7] Other possible symptoms include gaze palsies or hemisensory loss. [7] Intracerebral hemorrhage into the cerebellum may cause ataxia, vertigo, incoordination of limbs and vomiting. [7]
Epidural hematoma involves bleeding into the area between the skull and the dura mater, the outermost of the three membranes surrounding the brain. [11] In subdural hematoma, bleeding occurs between the dura and the arachnoid mater. [23] Subarachnoid hemorrhage involves bleeding into the space between the arachnoid membrane and the pia mater. [23]
Both direct blows to the head and blows to the body can produce subdural hematomas, diffuse cerebral edema, subarachnoid hemorrhage, and ischemic stroke, all pathologies that can lead to death. [40] By one estimate, the syndrome kills four to six people under the age of 18 per year. [33]
The other form is intraventricular hemorrhage). [1] Intraparenchymal hemorrhage accounts for approximately 8-13% of all strokes and results from a wide spectrum of disorders. It is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage, and therefore constitutes an immediate medical emergency.
This subdural hematoma/epidural hematoma (arrows) is causing midline shift of the brain. Doctors detect midline shift using a variety of methods. The most prominent measurement is done by a computed tomography (CT) scan and the CT Gold Standard is the standardized operating procedure for detecting MLS. [5]