Coleção subdural na criança: fisiopatologia e tratamento

Gusmão, Sebastião; Silveira, Roberto Leal; Cabral Filho, Guilherme; Arantes, Aluízio; Jermani, Charles

doi:10.1590/S0004-282X1997000200015

Resumos

Nove crianças portadoras de coleção subdural (CSD) foram tratadas por meio de derivação subduro-peritoneal. Todas foram submetidas a controle com tomografia computadorizada do encéfalo. O tamanho da coleção subdural foi avaliado por medida de sua área no corte tomográfico por meio de morfologia quantitativa com planímetro. Ocorreu regressão completa ou quase completa da CSD em oito pacientes. Os resultados funcionais foram excelentes em quatro pacientes, bons em três e maus em dois. Foi feita uma revisão da fisiopatologia e do tratamento da CSD na criança.

coleção subdural na criança; derivação subduro-peritoneal; líquido cefalorraquidiano

Nine children harboring subdural effusions were treated by subduro peritoneal shunt. These patients were followed-up by CT scans. The area of the subdural effusions was measured by quantitative morphology with a planimeter. With the surgical treatment, the subdural effusion disappeared completely or near completely in 8 patients. The patient's functional state were excellent in 4, good in 3 and bad in 2 in the postoperative follow-up. We aldo reviewed the literature as far as the pathophysiology and the treatment of the subdural effusions are concerned.

subdural effusions in children; subdural peritoneal shunt; cerebrospinal fluid

Coleção subdural na criança fisiopatologia e tratamento

Subdural effusions in children: pathophysiology and treatment

Sebastião Gusmão; Roberto Leal Silveira; Guilherme Cabral Filho; Aluízio Arantes;Charles Jermani

Serviço de Neurocirurgia do Hospital Madre Teresa, Belo Horizonte, MG

RESUMO

Nove crianças portadoras de coleção subdural (CSD) foram tratadas por meio de derivação subduro-peritoneal. Todas foram submetidas a controle com tomografia computadorizada do encéfalo. O tamanho da coleção subdural foi avaliado por medida de sua área no corte tomográfico por meio de morfologia quantitativa com planímetro. Ocorreu regressão completa ou quase completa da CSD em oito pacientes. Os resultados funcionais foram excelentes em quatro pacientes, bons em três e maus em dois. Foi feita uma revisão da fisiopatologia e do tratamento da CSD na criança.

Palavras-chave: coleção subdural na criança, derivação subduro-peritoneal, líquido cefalorraquidiano.

ABSTRACT

Nine children harboring subdural effusions were treated by subduro peritoneal shunt. These patients were followed-up by CT scans. The area of the subdural effusions was measured by quantitative morphology with a planimeter. With the surgical treatment, the subdural effusion disappeared completely or near completely in 8 patients. The patient's functional state were excellent in 4, good in 3 and bad in 2 in the postoperative follow-up. We aldo reviewed the literature as far as the pathophysiology and the treatment of the subdural effusions are concerned.

Key words: subdural effusions in children, subdural peritoneal shunt, cerebrospinal fluid.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 5-fevereiro-1997.

Dr. Sebastião Gusmão - Rua Padre Rolim 921 apto 21 - 30130-090 Belo Horizonte MG - Brasil.

1. Adams JH, Graham DI, Gennarelli TA. Neuropathology of acceleration-induced head injury in the subhuman primate. In Grissman RG. Gildenberg PL (eds). Head Injury: basic and clinical aspects. New York: Raven Press. 1982:141-150.
2. Agostini E, Ralm H. Abdominal and thoracic pressures at different lung volumes. J Applied Physiol 1960;15:1087-1092.
3. Aicardi J, Goultieres F. Les épanchenents sous-duraux du nourrisson. Arch Franç Pédiat 1971;28:233-247.
4. Aoki N, Miztani H. Masuzawa H. Unilateral subdural peritoneal shunting for bilateral chronic subdural hematomas in infancy. Pediatrics 1985:63:134-137.
5. Aoki N, Masuzawa H. Bilateral chronic subdural hematomas without comunication between the hematoma cavities: treatment with unilateral subdural-peritonenl shunt Neurosurgery 1988,22:911-913.
6. Aoki N. Chronic subdural hematoma in infancy: clinical analysis of 30 cases in the CT era. J Neurosurg 1990:73:201-205.
7. Brotchi J, Bonnal A: Surgical treatment of subdural effusion in infants. Acta Neurochirurg 1976;23:59-67.
8. Capelle L, Pierre-Kahn A. Sainte-Rose C, Renier D, Hoppe-Hirsch E, Hirsch JF. Treatment of chronic subdural collection in infants by subdural peritoneostomy. Neurochirurgie 1989;35:404-411.
9. Collins WF, Pucci GL. Peritoneal drainage of subdural hematoma in infants. J Pediat 1961:58:482-485.
10. Dandy WF, Blakfan KD. Internal hydrocephalus: an experimental clinical and pathological study. Am J Dis Child 1914;8:406-482.
11. Duomarco JY. Solovey G. Concepto de presión intra-abdominal y estrutura física del abdomen. Medicina (Buenos Aires) 1942;2:155-163.
12. Duomarco J Y, Rimini R. La presión intra-abdominal en el hombre. In: Varela-Fuentes A, Munilla. Patologia digestiva. Tomo II. Buenos Aires: Fspasa Calpe 1947.
13. Ersahin Y, Mutluer S. A method for continuous external drainage in the management of infantile subdural collections. Childs Nerv Syst 1995; 11:418-420.
14. Filkelstcin H. Lehrbuch der Saugglinskrankheiten. Berlin: H. Kornfeld, 1905.
15. Forman PM. Chipps BE, Meyer GA. Managing chronic subdural hematoma and effusion in infants: a continuing dilemma. Tex Med 1974;70:62-66.
16. Francel PC. Park TS. Shaftrcy ME. Jane JA. Diagnosis and treatment of moderate and sevre head injury in infants and children. In Youmans JR. Neurological Surgery. Ed 4. Philadelphia: Saunders 1996:1730-1766.
17. Gardner W.l. Traumatic subdural hematoma with particular reference to the latent interval. Arch Neurol Psychial 1932;27:847-855.
18. Gibson RM. Cannula for treatment of subdural effusions in infants by continuous drainage. Lancet 1960; 1:418-419.
19. Girard F. Hématomes sous-duraux expérimentaux. Paris. Journées de Pédiatrie, 1957:145-151.
20. Goodman JM. Mealey J. Postmeningitic subdural effusions: the syndrome and its management. .J Neurosurg 1969;30:658-663.
21. Gusmão S, Maitrot D. Hidrodinâmica da derivação ventricular. J Bras Neurocirurg 1990;2:37-44.
22. Hakim S, Venegas JG, Burton JD. The physics of the cranial cavity, hydrocephalus and normal pressure hydrocephalus. Surg Neurol 1976;5:187-209.
23. Herzberger E, Rotem Y, Braham J. Remarks on thirty-three cases of subdural effusions in infancy. Arch Dis Child 1956;31:44-50.
24. Holbourn AHS. Mechanics of head injuries. Lancet 1943;2:438-441.
25. Holbourn AHS. The mechanics of brain injuries. Br Med Bull 1945;3:147-149.
26. Hollenhorst RW. Stein HA, Keith HM, MacCarty LS. Subdural hematoma, subdural hygroma and subarachnoid hemorrhage among infants and children. Neurosurgery 1957;7:813-819.
27. Ingraham FD, Malson DD. Subdural hematoma in infancy. J Pediatr 1944;24:1 -37.
28. Ingraham FD, Malson DD. Neurosurgery of infancy and childhood. Springfield: Charles C. Thomas, 1954.
29. Kaufman HH, Childs TL, Wagner KA, Bernstein DP, Karon M, Khalid M, Gildenberg PL. Post-traumatic subdural hygromas: observations concerning a surgical enigma. Acta Neurochir 1984;72:197-209.
30. Kaufman HH. Glass F, Cohen G. Isodense acute subdural hematoma. J Comput Assist Tomogr 1980,4:557-559.
31. Konno K, Mead J. Static volume pressure characteristic of the rib cage and abdomen. J Applied Physiol 1958:24:544-548.
32. Lam C. Intra-abdominal pressure: a critical review and an experimental study. Arch Surg 1939:39:1006-1015.
33. Laterre EC. The normal protein pattern in cerebrospinal fluid. La Ricerca Clin Lav 1973:3:736-763.
34. Lcpintre J, Gorin R, Ducam H, Mozziconacci P. Etude de pronostic de 160 épanchements sous-duraux du nourrison en fonctionde leur étiologie et leur traitement. Ann Pediatrie 1972;19:481-489.
35. Litofsky NS, Raffel C, McComb JG. Management of symptomatic chronic extra-axial fluid collections in pediatric patients. Neurosurgery 1992;31:445-450.
36. Matge G. Contribution à I'étude des épanchements sous-duraux du nourrison. Thèse. Strasbourg, 1978.
37. Markwalder T. Chronic subdural hematomas: a review. J Neurosurg 1981;54:637-645.
38. McKay RJ, Ingraham FD, Matson DD. Subdural fluid complicating bacterial meningitis. JAMA 1953; 152:387-391.
39. McLaurin RL, Isaacs E, Lewis HP. Results of non operative treatment in 15 cases of infantile subdural hematoma. J Neurosurg 1971;34:753-759.
40. McLaurin RL, Rimpperman A. Management of post-traumatic subdural hematoma in infancy. Clin Neurosurg 1972:19:271-280
41. McLaurin RL, Towbin R. Diagnosis and treatment of head injury in infants and children. In Youmans JR. Neurological surgery. Ed 3. Philadelphia: Saunders, 1990:2149-2193.
42. Morota N, Sakamoto K, Kobayashi N, Kitazawa K, Kobayashi S. Infantile subdural fluid collection: diagnosis and postoperative course. Childs Nerv Syst 1995; 11:459-466.
43. Moyes PD, Thompson GB, Cluff JW. Subdural peritoneal shunts in the treatment of subdural effusions in infants. J Neurosurg 1965;23:584-587.
44. Neimann N, Montaut J, Sapelier J. Epanchements sous-duraux chroniques du nourisson. Paris: Expansion. 1968.
45. Njiokiktjicn CJ, Valk J, Ponssen H. Subdural hygroma: results of treatment by ventrictilo-abdoniinal shunt. Childs Brain 1980:7:285-302.
46. Posnikoff J. Techinique for transfontanelle subdural peritoneal shunting in subdural fluid collections of infancy. J Neurosurg 1968:28:169-172.
47. Pudenz RH, Shelden CH. The lucite calvarium: a method for direct observation of the brain: II. Cranial trauma and brain movement. J Neurosurg 1946;3:487-505.
48. Putnam TJ, Cushing H. Chronic subdural hematoma. Arch Surg 1925; 11:329-334.
49. Rabe EE Subdural effusions in infants. Pediatr Clin North Am 1967; 14:831 -850.
50. Rambaud P. Joannard A. Bost M, Barge M, Beaudouing A, Roget J. Collections sous-duralcs du nourrisson: considerations étiologiques, diagnostiques, thérapeutiques, évolutives. A propos de 60 observations. Pédiatric 197,27:127-133.
51. Ransohoff J. Chronic subdural hematomas treated by subduralpleural shunt. Pediatrics 1957;20:561 -564.
52. Rothenberger A, Brandl H. Subdural effusions in children under two years: clinical and computer tomographic data. Neuropediatrics 1980; 11:139-150.
53. Stroobandt G, Evrard P, Latcrrc C. Pahogénie des épanchements sous-duraux persistants du nourrisson. Neurochirurgie 1978;24:47-57.
54. Till K. Subdural hematoma and effusion in infancy. Br Med J 1968;3:400-402.
55. Tsubokawa T, Nakamura S, Satoh K. Effect of temporary subdural-periotneal shunt on subdural effusion with subarachnoid effusion. Childs Brain 1984;11:47-59.

Datas de Publicação

Publicação nesta coleção
10 Nov 2010
Data do Fascículo
Jun 1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams JH, Graham DI, Gennarelli TA. Neuropathology of acceleration-induced head injury in the subhuman primate. In Grissman RG. Gildenberg PL (eds). Head Injury: basic and clinical aspects. New York: Raven Press. 1982:141-150.

[2] 2. Agostini E, Ralm H. Abdominal and thoracic pressures at different lung volumes. J Applied Physiol 1960;15:1087-1092.

[3] 3. Aicardi J, Goultieres F. Les épanchenents sous-duraux du nourrisson. Arch Franç Pédiat 1971;28:233-247.

[4] 4. Aoki N, Miztani H. Masuzawa H. Unilateral subdural peritoneal shunting for bilateral chronic subdural hematomas in infancy. Pediatrics 1985:63:134-137.

[5] 5. Aoki N, Masuzawa H. Bilateral chronic subdural hematomas without comunication between the hematoma cavities: treatment with unilateral subdural-peritonenl shunt Neurosurgery 1988,22:911-913.

[6] 6. Aoki N. Chronic subdural hematoma in infancy: clinical analysis of 30 cases in the CT era. J Neurosurg 1990:73:201-205.

[7] 7. Brotchi J, Bonnal A: Surgical treatment of subdural effusion in infants. Acta Neurochirurg 1976;23:59-67.

[8] 8. Capelle L, Pierre-Kahn A. Sainte-Rose C, Renier D, Hoppe-Hirsch E, Hirsch JF. Treatment of chronic subdural collection in infants by subdural peritoneostomy. Neurochirurgie 1989;35:404-411.

[9] 9. Collins WF, Pucci GL. Peritoneal drainage of subdural hematoma in infants. J Pediat 1961:58:482-485.

[10] 10. Dandy WF, Blakfan KD. Internal hydrocephalus: an experimental clinical and pathological study. Am J Dis Child 1914;8:406-482.

[11] 11. Duomarco JY. Solovey G. Concepto de presión intra-abdominal y estrutura física del abdomen. Medicina (Buenos Aires) 1942;2:155-163.

[12] 12. Duomarco J Y, Rimini R. La presión intra-abdominal en el hombre. In: Varela-Fuentes A, Munilla. Patologia digestiva. Tomo II. Buenos Aires: Fspasa Calpe 1947.

[13] 13. Ersahin Y, Mutluer S. A method for continuous external drainage in the management of infantile subdural collections. Childs Nerv Syst 1995; 11:418-420.

[14] 14. Filkelstcin H. Lehrbuch der Saugglinskrankheiten. Berlin: H. Kornfeld, 1905.

[15] 15. Forman PM. Chipps BE, Meyer GA. Managing chronic subdural hematoma and effusion in infants: a continuing dilemma. Tex Med 1974;70:62-66.

[16] 16. Francel PC. Park TS. Shaftrcy ME. Jane JA. Diagnosis and treatment of moderate and sevre head injury in infants and children. In Youmans JR. Neurological Surgery. Ed 4. Philadelphia: Saunders 1996:1730-1766.

[17] 17. Gardner W.l. Traumatic subdural hematoma with particular reference to the latent interval. Arch Neurol Psychial 1932;27:847-855.

[18] 18. Gibson RM. Cannula for treatment of subdural effusions in infants by continuous drainage. Lancet 1960; 1:418-419.

[19] 19. Girard F. Hématomes sous-duraux expérimentaux. Paris. Journées de Pédiatrie, 1957:145-151.

[20] 20. Goodman JM. Mealey J. Postmeningitic subdural effusions: the syndrome and its management. .J Neurosurg 1969;30:658-663.

[21] 21. Gusmão S, Maitrot D. Hidrodinâmica da derivação ventricular. J Bras Neurocirurg 1990;2:37-44.

[22] 22. Hakim S, Venegas JG, Burton JD. The physics of the cranial cavity, hydrocephalus and normal pressure hydrocephalus. Surg Neurol 1976;5:187-209.

[23] 23. Herzberger E, Rotem Y, Braham J. Remarks on thirty-three cases of subdural effusions in infancy. Arch Dis Child 1956;31:44-50.

[24] 24. Holbourn AHS. Mechanics of head injuries. Lancet 1943;2:438-441.

[25] 25. Holbourn AHS. The mechanics of brain injuries. Br Med Bull 1945;3:147-149.

[26] 26. Hollenhorst RW. Stein HA, Keith HM, MacCarty LS. Subdural hematoma, subdural hygroma and subarachnoid hemorrhage among infants and children. Neurosurgery 1957;7:813-819.

[27] 27. Ingraham FD, Malson DD. Subdural hematoma in infancy. J Pediatr 1944;24:1 -37.

[28] 28. Ingraham FD, Malson DD. Neurosurgery of infancy and childhood. Springfield: Charles C. Thomas, 1954.

[29] 29. Kaufman HH, Childs TL, Wagner KA, Bernstein DP, Karon M, Khalid M, Gildenberg PL. Post-traumatic subdural hygromas: observations concerning a surgical enigma. Acta Neurochir 1984;72:197-209.

[30] 30. Kaufman HH. Glass F, Cohen G. Isodense acute subdural hematoma. J Comput Assist Tomogr 1980,4:557-559.

[31] 31. Konno K, Mead J. Static volume pressure characteristic of the rib cage and abdomen. J Applied Physiol 1958:24:544-548.

[32] 32. Lam C. Intra-abdominal pressure: a critical review and an experimental study. Arch Surg 1939:39:1006-1015.

[33] 33. Laterre EC. The normal protein pattern in cerebrospinal fluid. La Ricerca Clin Lav 1973:3:736-763.

[34] 34. Lcpintre J, Gorin R, Ducam H, Mozziconacci P. Etude de pronostic de 160 épanchements sous-duraux du nourrison en fonctionde leur étiologie et leur traitement. Ann Pediatrie 1972;19:481-489.

[35] 35. Litofsky NS, Raffel C, McComb JG. Management of symptomatic chronic extra-axial fluid collections in pediatric patients. Neurosurgery 1992;31:445-450.

[36] 36. Matge G. Contribution à I'étude des épanchements sous-duraux du nourrison. Thèse. Strasbourg, 1978.

[37] 37. Markwalder T. Chronic subdural hematomas: a review. J Neurosurg 1981;54:637-645.

[38] 38. McKay RJ, Ingraham FD, Matson DD. Subdural fluid complicating bacterial meningitis. JAMA 1953; 152:387-391.

[39] 39. McLaurin RL, Isaacs E, Lewis HP. Results of non operative treatment in 15 cases of infantile subdural hematoma. J Neurosurg 1971;34:753-759.

[40] 40. McLaurin RL, Rimpperman A. Management of post-traumatic subdural hematoma in infancy. Clin Neurosurg 1972:19:271-280

[41] 41. McLaurin RL, Towbin R. Diagnosis and treatment of head injury in infants and children. In Youmans JR. Neurological surgery. Ed 3. Philadelphia: Saunders, 1990:2149-2193.

[42] 42. Morota N, Sakamoto K, Kobayashi N, Kitazawa K, Kobayashi S. Infantile subdural fluid collection: diagnosis and postoperative course. Childs Nerv Syst 1995; 11:459-466.

[43] 43. Moyes PD, Thompson GB, Cluff JW. Subdural peritoneal shunts in the treatment of subdural effusions in infants. J Neurosurg 1965;23:584-587.

[44] 44. Neimann N, Montaut J, Sapelier J. Epanchements sous-duraux chroniques du nourisson. Paris: Expansion. 1968.

[45] 45. Njiokiktjicn CJ, Valk J, Ponssen H. Subdural hygroma: results of treatment by ventrictilo-abdoniinal shunt. Childs Brain 1980:7:285-302.

[46] 46. Posnikoff J. Techinique for transfontanelle subdural peritoneal shunting in subdural fluid collections of infancy. J Neurosurg 1968:28:169-172.

[47] 47. Pudenz RH, Shelden CH. The lucite calvarium: a method for direct observation of the brain: II. Cranial trauma and brain movement. J Neurosurg 1946;3:487-505.

[48] 48. Putnam TJ, Cushing H. Chronic subdural hematoma. Arch Surg 1925; 11:329-334.

[49] 49. Rabe EE Subdural effusions in infants. Pediatr Clin North Am 1967; 14:831 -850.

[50] 50. Rambaud P. Joannard A. Bost M, Barge M, Beaudouing A, Roget J. Collections sous-duralcs du nourrisson: considerations étiologiques, diagnostiques, thérapeutiques, évolutives. A propos de 60 observations. Pédiatric 197,27:127-133.

[51] 51. Ransohoff J. Chronic subdural hematomas treated by subduralpleural shunt. Pediatrics 1957;20:561 -564.

[52] 52. Rothenberger A, Brandl H. Subdural effusions in children under two years: clinical and computer tomographic data. Neuropediatrics 1980; 11:139-150.

[53] 53. Stroobandt G, Evrard P, Latcrrc C. Pahogénie des épanchements sous-duraux persistants du nourrisson. Neurochirurgie 1978;24:47-57.

[54] 54. Till K. Subdural hematoma and effusion in infancy. Br Med J 1968;3:400-402.

[55] 55. Tsubokawa T, Nakamura S, Satoh K. Effect of temporary subdural-periotneal shunt on subdural effusion with subarachnoid effusion. Childs Brain 1984;11:47-59.