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Vickie
Vickie, Nurse (RN)
Category: Health
Satisfied Customers: 85
Experience:  7 years exp. on surgical floor, plus many other areas, Emergency Medical tech, 19 yrs total medical.
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Is there any liquid in the Sub Dural area of the brain normally

Customer Question

My husband, Carle has a subdural hematoma. He has had drainage through burr holes in his head at which time 188 cc was removed. He still has residual blood and the neurosurgeon wants to do another procedure to remove the remaining blood. One neurosurgeon suggested 2 more burr holes and if that doesn't work he wants a full craniotomy with removal of thin membrane in dura. A second neuro surgeon suggests a shunt and empty the blood into his belly. He is a 75 year old man and has no acute symptoms at this time. The hematoma was caused after taking Plavix for his heart stent. He then hit his head at the temple area causing a slow bleed. When he began to stumble and lose his motor skills on the right side we went to ER for CT Scans and discovered the subdural. Please tell me if another procedure is really necessary. If there is normally fluid in the subdural area, how much?
Submitted: 11 years ago.
Category: Health
Expert:  Vickie replied 11 years ago.

DearCustomer


First of all, let me say how sorry I am about your husband's condition. The very best thing...In my opinion, is to listen to your neurosurgeons. They are the most informed of his condition at the moment, and have both the knowledge and technology to give your husband the best chance for a meaningful life. What is going on with him at the moment, as you know is very serious, and I would like to help you to understand better what is happening at the moment and try to address your issues also. A hematoma- is a collection of blood due to a tissue injury or the tearing of a blood vessel. CT scans done at the hospital are particularly effective in detecting brain bleeds. Bleeding into the brain after trauma can occur days after the patient is released from the emergency room. The dura is a tough membrane that covers the entire brain and spinal cord. A blood clot that develops outside the dura, between the skull and dura, is known as an epidural hematoma. A blood clot that develops between the dura and the brain is called a subdural hematoma. Gently resting against the brain itself is a thin, delicate membrane called the arachnoid. Underneath the arachnoid, between the arachnoid and the brain itself, is cerebrospinal fluid bathing and circulating around the brain. Blood leaking into the cerebrospinal fluid is known as a sub-arachnoid hemorrhage. In the days and weeks after a traumatic brain injury, patients are monitored closely for any sign of increased intracranial pressure (ICP), a dangerous complication in which the brain’s soft tissues become squeezed against the skull. This occurs when trauma to the head causes damaged blood vessels to leak or form clots (hematomas) or produces an imbalance in the amount of cerebrospinal fluid (CSF) in the ventricles. Because the skull is rigid and the space between it and the brain is small, there is no room for expansion. Extra fluid or clots in the brain (intercerebral clots) or the space between it and the skull (subdural or extradural clots) produce increased pressure, which can damage the brain in two ways: (1) by squeezing it against the skull or (2) by compressing its blood vessels to the point where circulation is impeded. Either complication can be fatal. Cerebrospinal fluid surrounds the brain and spinal cord, and although I am not sure of the exact amount a person has, I do know that it is replenished several times throughout 24 hours. The subdural space is known as a "potential space", and while the cerebrospinal fluid is not there, it is underneath that area between the arachnoid and brain itself. I have listed a few websites for your reference, that might help explain things a little better.


http://www.angelfire.com/wa/wafshaf50/CSF.html


http://www.gfilc.com/TBI,%20Main.htm


http://www.braininjury.com/injured.html


Good Luck to you and your husband, You are in my prayers.


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