Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Subdural Space”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed1984

Computed tomography of intracranial extramedullary hematopoiesis.

Patients with extramedullary hematopoiesis may be divided into two main groups. The first group shows paraosseous foci that may result from "herniation" of medullary tissue from the underlying bone. This is seen in hemolytic disorders where the marrow has tremendous activity. The second group shows extraosseous soft tissue foci, which may arise from multipotential stem cells. This occurs when the marrow activity is ineffectual, as in the myeloproliferative disorders or, rarely, with toxic or tumoral marrow destruction. We present a patient with myelosclerosis and four intracranial masses of hematopoietic tissue in the subdural space. We believe this is the first description of the cranial CT findings in this condition.

Bone Marrow↗
PubMed1981

[Acute subdural hygroma in the posterior fossa (author's transl)].

A 2-year-old girl was admitted to Chugoku Rosai Hospital one hour after a car accident on July 16, 1978. On admission she was conscious and no physical or neurologic abnormality was found. However, 2 hours and a half after the accident, she was attacked suddenly by generalized convulsion, and then became comatose with apnea. Bilateral horizontal nystagmus to the left, rhythmic constriction and dilation of the pupils reacting to light, and flaccid tetraplegia were recognized. Plain skull films revealed a linear fracture in the right posterior fossa, which crossed the transverse this region. A burr hole was made in the left posterior fossa, and slightly xanthochromic fluid, 30 to 40 microliter in volume, under high pressure was evacuated from the subdural space. A burr hole on the right side disclosed no abnormality. Spontaneous respiration returned immediately and consciousness became clear 5 hours after the surgery. No neurologic deficit was detect and postoperative EEG was normal. She was discharged from the hospital on July 27, 1978. Ten cases of acute subdural hygroma in the posterior fossa, including the present case, were analyzed. This lesion is able to be cured completely by a simple operation even in coma with apnea, if diagnosis made promptly and the surgery is carried out without delay. In cases of acute head injury, it is quite important to have a possibility of the infratentorial lesion in mind and to find it with the aids of plain skull film of Towne's view, CT scan, and VAG if necessary.

Acute Disease↗
PubMed1977

[Spinal subdural abscess-report of a case (author's transl)].

A successfully treated case with a spinal subdural abscess in the lumbar region is reported. The patient, a 58-year-old male, had been suffered from fever and pain in the back for 2 months prior to the visit to a hospital, where pus was obtained through a lumbar puncture. He was then admitted to the Neurosurgical Clinic, Gunma University Hospital on September 6, 1974. On admission, neurological examination revealed an alert patient with flaccid paraparesis, sensory disturbance in bilateral lower limbs and urinary retention. Stiffness of the neck and Lasègue's sign were observed. The body temperature was 38.7 degrees C, white blood cell count 18,900/mn3, and erythrocyte sedimentation rate 118 mn per hour. Pus was again obtained from the spinal canal through a lumbar puncture between the fourth and fifth lumbar vertebrae. Cerebrospinal fluid obtained by a cisternal puncture was colorless clear, and the cell count was 60 WBCs/mn3, protein 154 mg/dl, and glucose 90 mg/dl. Plain roentgenograms of the spine were normal. Myelography showed a block at the level of the first thoracic vertebra, being accompanied with irregular subarachnoid defects. A lumbar laminectomy was performed on September 12, and an abscess adhering to the cauda equina was totally extirpated from the subdural space. Smear of the pus contained Gram-positive bacilli, but the culture was negative. Postoperative course was uneventful, and the neurological deficits were gradually improved. Fifteen months later, the patient could walk with a stick. A review of the available literature, including the present report, lists 14 cases with spinal subdural abscesses which have been induced via hematogenous spread. The symptomotology, clinical diagnosis, treatment and prognosis are briefly discussed. It should be emphasized that early diagnosis and emergency treatment are of choice in order to obtain an excellent operative morbidity.

Abscess↗
PubMed1988

Inadvertent subdural injection: a complication of an epidural block.

Twenty-one hundred eighty two consecutive lumbar epidural injections were studied to determine the incidence of inadvertent subdural block retrospectively. A subdural block is defined as an extensive neural block in the absence of subarachnoid puncture, that is out of proportion to the amount of local anesthetic injected. Subdural injection is a complication of epidural block that probably occurs more frequently than previously recognized. An earlier report has estimated the incidence of subdural block to be 0.1%. This study, however, reports an incidence of 0.82% from a sample size of 2182 patients. Cadaveric dissection was also performed, further clarifying the presence and anatomic position of the subdural space.

Adolescent↗
PubMed2002

[A case of gastrectomy under continuous subdural anesthesia].

Unintentional subdural block, while attempting epidural block, is known as a complication. The authors used a catheter which had happened to be introduced into the subdural space, for clinical anesthesia and postoperative pain relief. For a 75-year-old male patient, gastrectomy was scheduled under epidural anesthesia. Epidural puncture was at the T 7 and T 8 interspace using loss of resistance method with saline under fluoroscopic guidance. We examined the catheter position by injecting iopamidol and confirmed subdural catheterization by subsequent computed tomography. After obtaining informed consent and agreement from the patient, "subdural anesthesia" was conducted. Ten ml of 0.5% bupivacaine was injected with 20 mg ephedrine as an initial dose. Twenty min after the injection, pin pricking revealed that analgesia had extended from the C 5 to S 1 dermatoms. Consciousness was clear and blood pressure was stable. Then, surgery was started. Since blood pressure tended to fall down gradually, we injected 40 mg of ephedrine subcutaneously 45 min after the subdural injection. At a 2 hours interval from the initial subdural injection, 5 ml of 0.5% bupivacaine was additionally injected. Respiration was stable throughout the surgery and the surgery was finished uneventfully. Analgesic level was from C 5 through S 3 at the end of surgery. Bupivacaine 0.25% was continuously infused at a rate of 2 ml.h-1 for 7 days for postoperative pain relief. The patient never complained of pain during the period. This report demonstrates that subdural block has a potential capability as an anesthesia for laparotomy as far as it is managed properly.

Aged↗
PubMed2003

Dural haemorrhage in non-traumatic infant deaths: does it explain the bleeding in 'shaken baby syndrome'?

A histological review of dura mater taken from a post-mortem series of 50 paediatric cases aged up to 5 months revealed fresh bleeding in the dura in 36/50, the bleeding ranging from small perivascular haemorrhages to extensive haemorrhage which had ruptured onto the surface of the dura. Severe hypoxia had been documented clinically in 27 of the 36 cases (75%). In a similar review of three infants presenting with classical 'shaken baby syndrome', intradural haemorrhage was also found, in addition to subdural bleeding, and we believe that our findings may have relevance to the pathogenesis of some infantile subdural haemorrhage. Recent work has shown that, in a proportion of infants with fatal head injury, there is little traumatic brain damage and that the significant finding is craniocervical injury, which causes respiratory abnormalities, severe global hypoxia and brain swelling, with raised intracranial pressure. We propose that, in such infants, a combination of severe hypoxia, brain swelling and raised central venous pressure causes blood to leak from intracranial veins into the subdural space, and that the cause of the subdural bleeding in some cases of infant head injury is therefore not traumatic rupture of bridging veins, but a phenomenon of immaturity. Hypoxia with brain swelling would also account for retinal haemorrhages, and so provide a unified hypothesis for the clinical and neuropathological findings in cases of infant head injury, without impact or considerable force being necessary.

Diagnosis, Differential↗
PubMed2002

Intracranial tumoural haemorrhage--a report of 58 cases.

In order to study the computerized tomographic (CT) appearances and clinical characteristics of intracranial tumoural haemorrhage (ITH), we analyzed retrospectively fifty-eight patients with ITH and reviewed the literature. As a result, 91% patients had acute or subacute onset and 26% manifested haemorrhage as their first symptoms. CT scanning indicated that intratumoural bleeding occurred in 23 cases, bleeding into parenchyma 18 cases, subarachnoid space 6 cases, ventricle 3 cases and subdural space 8 cases. Thirty-eight patients had emergency operations and the others had selective operations. Both tumours and haematomas were removed all together in all patients. Fifty-five patients were cured or improved and three died during the perioperative stage in our series. Among the patients with ITH, there were 21 metastatic tumours, 19 gliomas, 10 meningiomas, 6 pituitary adenomas, 1 melanoma and 1 acoustic neurilemoma. The onset of most ITH resembled that of cerebrovascular diseases. The location of ITH and the CT appearances of ITH varied in different cerebral tumours. Radical removal of brain tumours with haemorrhage is an effective treatment for ITH, which can greatly decrease the perioperative mortality rate and improve the prognoses of patients.

Adenoma↗
PubMed1996

Subdural recording of ictal DC shifts in neocortical seizures in humans.

PURPOSE: Invasive ictal EEG recording is often necessary to delineate epileptogenic areas in patients with intractable partial epilepsy, but even intracranial ictal recordings often reveal ill-defined onset zones in neocortical epilepsy. We studied the physiologic significance of ictal direct current (DC) potentials recorded intracranially in human epilepsy. METHODS: We made intracranial ictal EEG recordings in three patients with intractable partial seizures arising from frontal, lateral temporal, and parietal neocortical areas by using closely spaced subdural electrodes (platinum in two patients and stainless steel in one patient) with both standard (1.5 Hz) and open (0.016 Hz) low-frequency filter (LFF) settings. RESULTS: The initial ictal pattern was localized to two to nine subdural electrodes and characterized by very low voltage and high-frequency rhythmic activity ("electrodecremental pattern"). A slow-rising negative potential (DC potential) was seen in a slightly more restricted area (two to six electrodes) and occurred 1-10 s before the initial ictal EEG discharges in two patients. CONCLUSIONS: These results agree with those of previous studies of ictal DC shifts in animals and suggest that ictal DC shifts may be helpful in delineating the epileptogenic area more precisely in human epilepsy.

Adolescent↗
PubMed2004

Flexible versus rigid catheters for chronic administration of exogenous agents into central nervous system tissues.

INTRODUCTION: Neuropharmacology studies depend on consistency in drug delivery. Drug infusions into central nervous system (CNS) tissues have been described as unreliable. Speculation has focused on infusion pumps as the source of variation. This report demonstrates that the catheter may be a source of variability. The inconsistency can be significantly reduced by a change in catheter design. METHODS: Normal and tumor cell-challenged (abnormal) brains of Fischer rats were infused with small and large molecular weight cytotoxic drugs via rigid and flexible catheters placed directly into the parenchyma. Coronal tissue sections rostral and caudal to the infusion point were analyzed for drug concentrations. Carboplatin, estimated through atomic absorption assays, and doxorubicin and transferrin-bound doxorubicin, measured by fluorescent spectroscopy, were mapped in serial sections at various distances from the infusion point. RESULTS: The expected drug distribution pattern approximates a bell-shaped curve with a maximum drug concentration near the infusion point and approximately equal, declining concentrations rostral and caudal to the infusion. This expected distribution was found in only 10 of the 17 normal brains and 15 of the 28 abnormal brains infused with a rigid catheter. In contrast, 10 of the 10 normal brains and 16 of the 16 abnormal rat brains infused with a flexible catheter had the expected distribution pattern. The distribution pattern was not associated with the molecular weight of the infused drug. CONCLUSION: Replacement of rigid infusion tubes with flexible tubing increases the reliability of local CNS drug infusions. Rigid catheters may allow backflow of the infused drug along the path of the catheters into the subdural space.

Animals↗
PubMed2006

Combined subdural and epidural block in a case of epidural catheterization for postoperative analgesia.

We report a case of unusual block caused by postoperative epidural analgesia for laparotomy in a gynecologic patient in consequence of inadvertent epidural catheterization. The clinical manifestation included agitation, spotty distribution of analgesia, wide spread of sensory block and loss of motor power. The radiological findings suggested a multicompartmental block with the anchorage of the catheter tip stretching over the epidural and subdural spaces. The default of catheter position was not detected during routine test dose procedure.

Analgesia, Epidural↗
PubMed2004

Spinal subdural empyema after a dural tear. Case report.

Spinal subdural empyema is an exceptionally rare and serious condition. Immediate surgery with complete exposure and drainage of the abscess is generally recommended. The authors present a patient in whom a Staphylococcus aureus septicemia related to nosocomial pneumonia developed after a thoracic laminectomy. The surgery was further complicated by an unintended durotomy (dural tear). Ten days postoperatively, the patient experienced back pain and lower-extremity symptoms caused by a subdural empyema. Cultures from the wound also grew S. aureus. This represents the first case of spinal subdural empyema in which the spread of infection into the subdural space is believed to have been facilitated by a dural tear. The patient had a favorable outcome despite an initial delay in surgical intervention because of a pulmonary embolus.

Aged↗
PubMed2004

Establishment of adult Parelaphostrongylus tenuis, patent infections, and acquired immunity after experimental infection of white-tailed deer (Odocoileus virginianus) and red deer (Cervus elaphus elaphus).

Experimental Parelaphostrongylus tenuis infections were established in white-tailed deer (Odocoileus virginianus) and an atypical host, red deer (Cervus elaphus elaphus). Groups of deer were fed 10, 25, or 100 third-stage larvae (L3) of P. tenuis and received a single equivalent challenge exposure at varying intervals. Infections were monitored up to 6 yr in white-tailed deer and up to 2.8 yr in red deer. The prepatent period in white-tailed deer varied from 91 to 1,072 days (381 +/- 374) and in red deer from 105 to 358 days (167 +/- 77). Adult worms lived for up to 6 yr in white-tailed deer. Although most had patent infections until necropsy, latent periods were observed regardless of season. Adult worms lived for up to 2.8 yr in red deer, and patent infections persisted for 20-363 days (152 +/- 106). Patent infections were correlated with the presence of adult worms in blood vessels and sinuses of both deer species. Worms were restricted to the subdural space in all deer with latent and occult infections. Adult worm recovery in white-tailed deer fed 10 or 25 L3 corresponded to the mean intensities reported in natural infections of white-tailed deer Recovery from deer fed 100 L3 was not typical of natural infection intensities. Adult P. tenuis established in all groups of red deer, but neurologic disease was restricted to animals fed 100 L3. Acute neurologic disease was associated with subdural hemorrhage and occurred at 11 mo postinfection in 2 red deer. The absence of postchallenge patent periods and the persistence of occult infections indicated that challenge exposures did not establish. These data indicate that acquired immunity to P. tenuis was established by 6 mo postinfection in both white-tailed and red deer. Latent periods in white-tailed deer and latent infections in red deer reinforce the need for a reliable diagnostic assay.

Animals↗
PubMed1991

Subdural compartment in pig: a morphologic study with blood and horseradish peroxidase infused subdurally.

The dura-arachnoid junction is examined in normal animals and in animals subjected to subdural infusion of blood immediately prior to death, simulating acute subdural hemorrhages. The Norwegian landrace pig is used as the experimental animal. Horseradish peroxidase (HRP) has been added to the injected blood to serve as a macromolecular tracer. The material is studied by light and electron microscopy. Special attention is given to the level of the induced subdural cleavage plane, the total distribution of the infused blood, and the natural sites of drainage. The dura-arachnoid junction, identified here as the subdural compartment (the dural border layer of others), consists of an avascular tissue with flake-like, relatively electron-lucent cells stacked upon each other in several layers with narrow intercellular clefts. Under normal conditions there is no evidence of a so-called "subdural space." When under the present experimental conditions bleeding takes place into this cellular tissue, it splits without any particular, predestined cleavage plane, although most often close to the fibrous matter of the dura. The bleeding extends throughout the cerebral and spinal parts of the compartment and also along the spinal nerve roots. Contamination of the subarachnoid space occurs only in some cases subjected to large infusions and apparently only at spinal levels. The HRP diffuses into the dura, but does not traverse the arachnoid barrier layer.

Animals↗
PubMed1983

Mesothelial cell integrity of the subdural and arachnoid surfaces of the cat brain after exposure to neurosurgical irrigation fluids and air: a scanning electron microscopic study.

The mesothelial cell integrity of the subdural and arachnoid surfaces in the cat was investigated by scanning electron microscopy after exposure to different irrigation fluids used in neurosurgery, as well as after drying by air. Irrigation for 3 hours with Elliott's Solution B and Ringer's solution retained the morphology of the cells. After exposure to saline for the same time, the mesothelial cells appeared perforated and were sometimes detached from the underlying connective tissue. Exposure to air for 15 minutes induced extensive, probably irreversible, cell damage. After 5 minutes of exposure to hydrogen peroxide, most cells disappeared, revealing the underlying collagenous connective tissue. These mesothelial cell changes might be one cause of the formation of postoperative subdural adhesions. In previous studies, disturbance of the blood-brain barrier was produced by those agents causing mesothelial cell damage. With hydrogen peroxide, widespread thrombosis occurred in leptomeningeal vessels supplying the cortex. Changes in these vessels can obviously be induced easily by fluids applied to the subdural space because of the close contact between the arachnoid and the adventitia of the vessels. This alternative should be considered in the treatment of cerebral vasospasm.

Animals↗
PubMed2000

Subdural applications of NO scavenger or NO blocker to the cerebellum depress the adaptation of monkey post-saccadic smooth pursuit eye movements.

We examined pharmacologically whether cerebellar long-term depression (LTD) may play a role in the adaptation of smooth pursuit eye movements in two Macaca fuscata, which were trained to pursue a target moving in the horizontal plane in a 3 degrees step-10 deg/s ramp mode. The monkeys showed small catch-up saccades followed by 6-8 deg/s post-saccadic pursuit movements. Adaptation of the post-saccadic pursuit velocity was induced by repetition of acceleration of the target to 20 deg/s after the catch-up saccades. Injections of 0.1 mM hemoglobin or 20 mM NG-monomethyl-L-arginine solution into the subdural space above the paraflocculus-flocculus scarcely affected the post-saccadic pursuit velocity, but markedly depressed its adaptation. These observations suggest that cerebellar LTD may underlie the adaptation of smooth pursuit.

Animals↗
PubMed1985

Subdural meningioma of spinal cord. Case report.

A case of extensive circumferential meningioma of the spinal subdural space is reported. A potential mechanism for this growth pattern is proposed, and preoperative diagnosis by computerized tomography is discussed. This case reinforces the necessity for intradural exploration when an expected extradural neoplasm is not encountered at operation.

Adult↗
PubMed1991

Subdural application of hemoglobin to the cerebellum blocks vestibuloocular reflex adaptation.

Vestibuloocular reflex (VOR) was induced by horizontal sinusoidal whole-body rotation in darkness in rabbits and a monkey. One eye was observed through an infrared TV camera. The gain of VOR was adaptively changed when the animal was continuously rotated for 3 h with the observed eye exposed to the screen moving in phase or out of phase with the head. Injection of 0.1 ml saline solution containing 10 microM hemoglobin into the subdural space over the cerebellar flocculus ipsilateral to the observed eye abolished the VOR adaptation. Since hemoglobin absorbs nitric oxide, which mediates synaptic plasticity in the cerebellar cortex, these results support the view that synaptic plasticity of the flocculus plays a key role in the VOR adaptation.

Adaptation, Physiological↗