Histological dating of subdural hematoma in infants
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Dating of Early Subdural Haematoma: A Correlative Clinico-Radiological Study
Dating subdural hematomas. Journal of admission was used to accurately date sdhs. We aimed to do so, poisoning; accepted date: september 07, try the brain beneath its outer covering. When blood cells of the subdural hemorrhages. Subdural hematomas and find a common variant of the brain.
Acute Subdural Haematoma. (SDH) is the collection of blood between the dural and the. arachnoid layers of the meninges. It is one of the most.
A chronic subdural hematoma is an “old” collection of blood and blood breakdown products between the surface of the brain and its outermost covering the dura. The chronic phase of a subdural hematoma begins several weeks after the first bleeding. A subdural hematoma develops when bridging veins tear and leak blood.
These are the tiny veins that run between the dura and surface of the brain. This is usually the result of a head injury. A collection of blood then forms over the surface of the brain. In a chronic subdural collection, blood leaks from the veins slowly over time, or a fast hemorrhage is left to clear up on its own. A subdural hematoma is more common in older adults because of normal brain shrinkage that occurs with aging. This shrinkage stretches and weakens the bridging veins. These veins are more likely to break in older adults, even after a minor head injury.
You or your family may not remember any injury that could explain it. In some cases, there may be no symptoms. However, depending on the size of the hematoma and where it presses on the brain, any of the following symptoms may occur:. Your health care provider will ask about your medical history.
Click on image for details. Subdural hemorrhage of infancy: Is it spontaneous? Correspondence Address : Dr. Subdural haematoma and effusion in infancy: An epidemiological study. Arch Dis Child ; Sgouros S, Tolias C.
Hobbs et al report an incidence of subdural haematoma/effusion in infancy from all of age (and per aged 0–2) in the largest UK study to date.
Chronic subdural hematoma CSDH is prevalent among elderly populations worldwide, and its mysterious pathogenesis has been discussed in the literature for decades. The issues remaining to be solved in regard to CSDH include the initiating events; the bleeding into the subdural space and the formation of the outer and inner membranes, its development; increase and liquefaction of hematoma, the optimal treatments, and the natural history. The pathophysiology is becoming more clear due to recent findings from computed tomography studies and human models of CSDH.
In this work, we review previous studies on CSDH and present a new integrated concept about the development of this common condition after head injuries. Already have an account? Login in here. Journal of Medical and Dental Sciences.
Chronic subdural hematoma
Microscopic study of the organization of the Subdural Haemorrhage SDH verified against the time period can help us in the determination of its age which has serious medico-legal implications. Very few studies concerning the dating of SDH are present in the literature. This study was conducted for dating the early subdural haemorrhage by routine histopathological stains.
No study to date has addressed the role of child protective investigation into the cause and management of subdural hematoma in children who lack other indi-.
After infant deaths due to non-accidental head injury NAHI with subdural hematoma SDH , the magistrates ask experts to date the traumatic event. To do so, the expert only has tools based on adult series of NAHI. We aimed to develop an SDH dating system applicable to infants aged under 3 years. We studied a retrospective multicenter collection of infants who died between the ages of 0 and 36 months, diagnosed with SDH by forensic pathological examination and with known posttraumatic interval PTI.
Two pathologists assessed blindly and independently 12 histomorphological criteria relating to the clot and 14 relating to the dura mater in 73 victims 31 girls, 42 boys whose median age was 3. Histopathological changes were significantly correlated with PTI for the appearance of red blood cells RBCs and the presence or absence of siderophages, and regarding the dura mater, the quantity of lymphocytes, macrophages, and siderophages; presence or absence of hematoidin deposits; collagen and fibroblast formation; neomembrane thickness; and presence or absence of neovascularization.
Dating systems for SDH in adults are not applicable to infants. Notably, neomembrane of organized connective tissue is formed earlier in infants than in adults. Our dating system improves the precision and reliability of forensic pathological expert examination of NAHI, particularly for age estimation of SDH in infants. However, the expert can only define a time interval. Histopathology is indispensable to detect repetitive trauma.
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Dating of Acute and Subacute Subdural Haemorrhage: A Histo-Pathological Study
Determination of post-traumatic interval remains one of the foremost important goals of any forensic investigation related to human crimes. The estimation of time since injury in cases of subdural haemorrhage has been studied only by a few investigators on the histological and radiological front. The study included a total of cases of closed head injury with subdural haemorrhage. Statistically significant results were obtained between the HU measurements of the SDH and the post-traumatic intervals and were found to be statistically significant.
The incidence of subdural hematoma (SDH) has been increasing since Information recorded includes the date each prescription was filled.
A subdural hematoma forms because of an accumulation of blood under the dura mater, one of the protective layers to the brain tissue under the calvarium. The understanding of subdural hematoma relies on the knowledge of neuroanatomical sheets covering the brain. The brain is the central repository of delicate neural tissue. This network of neurons and neuronal connective tissue is prone to injury without the protective layers, starting with the scalp and the bony structures of the skull.
First, there is a leather-like structure called the dura mater , derived from the neural crest, adhering to the periosteum and facing the other meningeal structure, the arachnoid mater. These so-called bridging veins may rupture when direct opposing forces rupture their thin walls, releasing blood under the dura mater forming a subdural hematoma. In this context, the structure stretches bridging veins and renders them prone to rupture. In the pediatric patient, trauma is the most common cause of subdural hematoma.
Contributing factors include blunt and shearing injuries. Cranium extraction device use and traumatic birth delivery accounts for a majority of the SDH in the newborn period. A subdural hematoma is one of the intracranial injuries associated with abusive head trauma AHT. Other injuries discovered with AHT include epidural hematoma, diffuse axonal injury and parenchymal injury among others.
The Role of the Iron Stain in Assessing Intracranial Hemorrhage
The timing of the breakdown of red blood cells and organization of hemorrhage has significance in the catabolism of heme and the processing of iron, but also has a practical application in terms of assigning, or attempting to assign, a time course with respect to traumatic events e. Attempts to date contusions, however, have generally been unsuccessful by macroscopic observation, whereas the microscopic observations provide broad data but are also anatomically imprecise as a function of time.
Intracranial lesions are of particular significance with respect to the timing of organizing hemorrhage given the acute, and often life-threatening nature of the hemorrhages, and the medicolegal investigation into potential crimes. Of concern is that the Prussian Blue reaction for iron, a relatively straightforward histochemical reaction that has been in use for over years, is sometimes suggested as a diagnostic test for chronicity.
Showing results for Subdural hematoma. All; Adult; Pediatric; Patient; Graphics. Click related term for subdural hematoma: intracranial hemorrhage · Subdural.
After infant deaths due to non-accidental head injury NAHI with subdural hematoma SDH , the magistrates ask experts to date the traumatic event. To do so, the expert only has tools based on adult series of NAHI. Two pathologists assessed blindly and independently 12 histomorphological criteria relating to the clot and 14 relating to the dura mater in 73 victims 31 girls, 42 boys whose median age was 3. Histopathological changes were significantly correlated with PTI for the appearance of red blood cells RBCs and the presence or absence of siderophages, and regarding the dura mater, the quantity of lymphocytes, macrophages, and siderophages; presence or absence of hematoidin deposits; collagen and fibroblast formation; neomembrane thickness; and presence or absence of neovascularization.
Dating systems for SDH in adults are not applicable to infants. Notably, neomembrane of organized connective tissue is formed earlier in infants than in adults. Our dating system improves the precision and reliability of forensic pathological expert examination of NAHI, particularly for age estimation of SDH in infants. However, the expert can only define a time interval. Histopathology is indispensable to detect repetitive trauma. This is a preview of subscription content, log in to check access.
Dating subdural hematomas
SDH can happen in any age group, is mainly due to head trauma and CT scans are usually sufficient to make the diagnosis. Prognosis varies widely depending on the size and chronicity of the hemorrhage. Subdural hematomas, most frequently due to trauma, are seen in all age-groups although etiology will vary 4,5 :.
Acute subdural hemorrhages usually present in the setting of head trauma.
The high incidence of subdural hematoma (SDH) from birthing was first identified even though at times there is a trajectory of head enlargement dating to birth.
A subdural hematoma occurs when a blood vessel near the surface of the brain bursts. Blood builds up between the brain and the brain’s tough outer lining. The condition is also called a subdural hemorrhage. In a subdural hematoma, blood collects immediately beneath the dura mater. The dura mater is the outermost layer of the meninges. The meninges is the three-layer protective covering of the brain.
Evaluation of the age of subdural hematomas by computerized tomography
The incidence of traumatic brain injuries is increasing globally, largely due to an increase in motor vehicle use in low-income and middle-income countries. Purpose The aim of study was to investigate the factors that modulate the prognosis of patients with traumatic acute subdural hematoma. All the data collected were statistically analyzed and the results were compared with the international results.
Our recommendations were based on that comparison. Results Mortality rate was
Dating of Early Subdural Haematoma: A Correlative Clinico-Radiological Study. Murali Gundu Rao, Dalbir Singh, [ ], and Suresh Kumar.
A subdural hematoma is a serious, and potentially life-threatening, head injury that occurs when blood collects between the brain’s cover known as the dura and its surface. A subdural hematoma is not something you can diagnose at home, though you may suspect you have one based on symptoms. Any head injury is a medical emergency that has the potential to become life-threatening. So if you have recently suffered a blow to the head, have signs of a stroke, or have experienced a change in consciousness or personality, don’t delay seeking medical help.
Prompt medical assistance is the single best predictor of recovery from any head injury, including subdural hematomas. Without proper medical intervention, death can occur in just a few hours. A subdural hematoma occurs when the tiny blood vessels within the brain’s dura tear, causing blood to pool in the brain. The bleeding can quickly fill the brain, compressing parts of the brain, impeding brain function, leading to organ failure, and even causing death.
Doctors have identified two types of subdural hematomas.