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A CASE OF ACUTE TRAUMATIC EPIDURAL HYDROPS Yuji Miyazaki 1 1Department of Neurological Surgery, Sapporo Medical College and Hospital pp.1063-1068
Published Date 1973/8/1
DOI https://doi.org/10.11477/mf.1406203362
  • Abstract
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Many authors has been discussed on the traumatic subdural hydrops and hygroma but no paper relat-ing to cerebrospinal fluid accumulation in epidural space after closed head injury is presented in the literature.

The author experienced a case of epidural accu-mulation of cerebrospinal fluid in acute stage of head injury and this epidural accumulation of cerebrospinal fluid was cause of neurological evi-dences. The author presume that this cause is unique case.

43 year old man of clear consciousness admitted 28 hours after head injury with complaint of com-plete palsy of left arm and moderate weakness of left leg which appeared 25 hours following head injury. The plain skull films showed hook-shapedlinear fracture in the area of right coronal suture. The right carotid angiogram revealed lens-shaped avascular area with shifting of anterior cerebral artery to opposite side. The diagnosis of epidural hematoma was made.

In the course of craniotomy, 100ml of clear fluid spout out in hight of 10 cm by procedure of first burr hole. Very thin blood clot in size of 5cm × 5cm and 5mm in thickness was encountered by craniotomy. No dural laceration which allowed of flow out of cerebrospinal fluid was observed.

It is not doubt that accumulation of cerebrospinal fluid in the epidural space was cause of avascular area in the carotid angiogram and compression to brain.

The author suppose following two conditions occurred in the dura mater by head injury in this case. The one is separation of dura mater from the inner surface of skull and the other one is splitting of fibers consist of dura mater. The former made a epidural pocket which allowed ac-cumulation of cerebrospinal fluid and the latthr made a tiny hole which allowed flow out of cerebro-spinal fluid.

The author named acute traumatic epidural hy-drops for accumulation of cerebrospinal fluid in the epidural space after closed head injury.


Copyright © 1973, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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