Abstract
In spite of a great number of works dedicated to chronic subdural hematoma, the understanding of its hysiopathogenesis still remains debatable. The discussions which concerned Virchow’s concept of pachymeningitis hemorrhagica interna29, 40,153, 183,186 are nearly forgotten and every neurosurgeon nowadays agrees upon the bold outline written by Gushing (1925) in the preface to Doctor Putnam’s dissertation: “In the majority of cases, and perhaps in all, they follow on a trauma so insignificant as to be commonly forgotten by the patient or overlooked in the anamnesis; that the diagnosis should always be considered in a history of mild trauma followed after a latent interval, often of surprising length, by severe headaches associated with psychoses; that, a correct diagnosis being made, the indications for operation are as definite as those for the well recognized extradural hemorrhages associated with fracture of the skull; that perfect recovery is to be expected on evacuation of the clot; that continuance or recurrence of the bleeding is unusual, and, finally, that one’s ideas of so-called pachymeningitis hemorrhagica interna with its supposed spontaneous and successive bleedings may possibly have to be entirely recast.”
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Brihaye, J. (1986). Chronic Subdural Hematoma. In: McLaurin, R.L. (eds) Extracerebral Collections. Advances in Neurotraumatology, vol 1. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8805-7_3
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