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Epidural haematoma: Pathophysiological significance of extravasation and arteriovenous shunting

An analysis of 35 patients

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Summary

35 patients with epidural bleeding operated on at Rikshospitalet, Oslo, during the period 1965–1980 had preoperative angiography with visualization of the external carotid artery. Twenty-one patients had extravasation of contrast medium from meningeal arteries. Seventeen of the 21 had also shunting of contrast medium from meningeal arteries to meningeal or diploic veins, while 20 of the 21 also had bled from a ruptured meningeal artery at operation. It was further found that of 20 patients who deteriorated after trauma 18 had an epidural arteriovenous shunt or extravasation. Conversely, of 15 patients who improved after trauma 12 had no evidence of a shunt. The strong correlation between the clinical course and the occurrence of extravasation supports previous experimental and clinical data, indicating the epidural arteriovenous shunt to be a major factor in the pathophysiology and the outcome of epidural bleeding.

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  1. N. N. Zwetnow (Professor and Head)

    Present address: Department of Neurosurgery, Rikshospitalet, The National Hospital, Oslo, Norway

Authors and Affiliations

  1. Department of Neurosurgery, Rikshospitalet, The National Hospital, Oslo, Norway

    A. H. Habash (Visiting Scientist)

  2. Department of Neuroradiology, Rikshospitalet, The National Hospital, Oslo, Norway

    O. Sortland (Acting Head)

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Habash, A.H., Sortland, O. & Zwetnow, N.N. Epidural haematoma: Pathophysiological significance of extravasation and arteriovenous shunting. Acta neurochir 60, 7–27 (1982). https://doi.org/10.1007/BF01401746

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