Clinical Analysis of Traumatic Subdural Hygroma and its Relation with Regional Cerebral Blood Flow Using 99mTc-HMPAO SPECT

Measurement of regional cerebral blood flow with single photon emission computed tomography(SPECT) was performed using 99mTc-HMPAO in 16 patients with traumatic subdural hygroma, and we investigated the relationships between the results and the initial clinical findings and clinical outcomes on 4-month after injury. In patients with complex subdural hygroma, improvement of perfusion on follow up SPECT was correlated with the clinical outcome. But in patients with simple subdural hygroma, the clinical outcomes were good regardless of cerebral perfusion on initial SPECT and cerebral hypoperfusion was improved on follow up SPECT in all patients. These results suggested that associated parenchymal injury, initial perfusion of the frontal cortex, and improvement of perfusion on follow up SPECT were good indicators of clinical outcome. In conclusion, HMPAO-SPECT can be helpful in predicting the prognosis and assessing the effect of surgical treatment in patients with traumatic subdural hygroma.

Post-Traumatic Cerebral Infarction

We report a series of 19 consecutive patients with post-traumatic cerebral infarction. Post-traumatic cerebral infarction(PTCI) was diagnosed by CT within 24 hours of admission in 6 cases and up to 14 days after admission in 13 cases of 1092 patients who required cranial CT for trauma during the period. The frequency, vaascular territories, cause, and mortality rate of post traumatic cerebral infarction were discussed.