Clinical evolutional aspects of chronic subdural haematomas - literature review.

Apparently trivial, one of the most frequent pathologies in neurosurgical practice, chronic subdural haematoma, continues to be a challenge for the neurosurgeons both from the therapeutic and postoperatory complications point of view, taking into account that it is frequently met in elders, who usually present a complex pathology. The fact that, by definition, there is a latent period between the moment the brain injury, usually minor, occurs and the appearance of clinical symptomatology, frequently makes the trauma be ignored, this complicating the diagnosis and most of the times delaying the application of the adequate treatment. Developing slowly in time, in weeks or months, the aspect that chronic subdural haematoma usually occurs in elders should not be neglected, its clinical symptomatology often debuting with memory and attention disorders, so that the patient is usually referred to psychiatrists or neurologists, only a paraclinical investigation (CT scan or MRI) being able to establish the diagnosis. Even the appearance of the lateral signs is subjected to many diagnosis confusions because patients deny the existence of a trauma in over 50% of the cases.

Cerebral dermoid tumours.

Four cases of cerebral dermoid tumour with an intraventricular, occipital and sellar location are reported, representing 0.04% of the verified cerebral tumours in the authors' statistics. A recurrence occurred after one year in the first case of intraventricular dermoid tumour; after the second operation aseptic meningitis developed and the patient died. In the second case microscopic examination revealed aspects of malignant transformation of the tumour. The symptoms did not differ from those of other cerebral tumours. Operations should be radical whenever possible, avoiding dispersion of the tumour contents in order to prevent a recurrence or aseptic meningitis.