Korean J Neurotrauma.  2015 Oct;11(2):27-34. 10.13004/kjnt.2015.11.2.27.

History of Chronic Subdural Hematoma

• Lee KS

• KMID: 2378255
• DOI: http://doi.org/10.13004/kjnt.2015.11.2.27

Abstract

Trephination or trepanation is an intentional surgical procedure performed from the Stone Age. It looks like escaping a black evil from the head. This technique is still used for treatment of chronic subdural hematoma (SDH). Now, we know the origin, pathogenesis and natural history of this lesion. The author try to explore the history of trephination and modern discovery of chronic SDH. The author performed a detailed electronic search of PubMed. By the key word of chronic SDH, 2,593 articles were found without language restriction in May 2015. The author reviewed the fact and way, discovering the present knowledge on the chronic SDH. The first authentic report of chronic SDH was that of Wepfer in 1657. Chronic SDH was regarded as a stroke in 17th century. It was changed as an inflammatory disease in 19th century by Virchow, and became a traumatic lesion in 20th century. However, trauma is not necessary in many cases of chronic SDHs. The more important prerequisite is sufficient potential subdural space, degeneration of the brain. Modifying Virchow's description, chronic SDH is sometimes traumatic, but most often caused by severe degeneration of the brain. From Wepfer's first description, nearly 350 years passed to explore the origin, pathogenesis, and fate of chronic SDH. The nature of the black evil in the head of the Stone Age is uncovering by many authors riding the giant's shoulder. Chronic SDH should be categorized as a degenerative lesion instead of a traumatic lesion.

Keyword

Hematoma, subdural, chronic; Trephination; History; Craniocerebral trauma; Aging

MeSH Terms

Aging
Brain
Craniocerebral Trauma
Head
Hematoma, Subdural, Chronic*
Natural History
Shoulder
Stroke
Subdural Space
Trephining
United Nations

Figure

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  FIGURE 1 People of the Stone Age might think that the black evil escaped from the head through a hole made by trepanation.

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  FIGURE 2 Pathological characteristics of subdural lesions. Modified from Lee KS. Natural history of chronic subdural haematoma. Brain Inj 18:351-358, 2004.31) Copyright 2004 by the Taylor & Francis. Reprinted with permission. CSF: cerebrospinal fluid, Mbr.: membrane.

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  FIGURE 3 Development of subdural hygroma and fate of chronic subdural hematoma. Modified from Lee KS, Bae WK, Park YT, Yun IG. The pathogenesis and fate of traumatic subdural hygroma. Br J Neurosurg 8:551-558, 1994.34) Copyright 1994 by the Taylor & Francis. Reprinted with permission. DBC: dural border cell, Br.: brain.

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  FIGURE 4 Origin and relations of subdural lesions. Modified from Lee KS, Bae WK, Park YT, Yun IG. The pathogenesis and fate of traumatic subdural hygroma. Br J Neurosurg 8:551-558, 1994.34) Copyright 1994 by the Taylor & Francis. Reprinted with permission. DBC: dural border cell, Br.: brain.

Reference

1. Andrushko VA, Verano JW. Prehistoric trepanation in the Cuzco region of Peru: a view into an ancient Andean practice. Am J Phys Anthropol. 2008; 137:4–13. PMID: 18386793.

2. Apfelbaum RI, Guthkelch AN, Shulman K. Experimental production of subdural hematomas. J Neurosurg. 1974; 40:336–346. PMID: 4813715.

3. Bereczki Z, Marcsik A. Trephined skulls from ancient populations in Hungary. Acta Medica Lithuanica. 2005; 12:65–69.

4. Campillo D. Neurosurgical pathology in prehistory. Acta Neurochir (Wien). 1984; 70:275–290. PMID: 6369893.

5. Capasso L, Michetti E, Pierfelice L, D'Anastasio R. Neurosurgery 7000 years ago in central Italy. Lancet. 2002; 359:2206. PMID: 12091016.

6. Cha KH, Kim CH, Lee HK, Moon JG, Cho TG. The Clinical Course of Subdural Hygroma with Head Injury. Korean J Neurotrauma. 2013; 9:125–130.

7. Clower WT, Finger S. Discovering trepanation: the contribution of Paul Broca. Neurosurgery. 2001; 49:1417–1425. discussion 1425-1426PMID: 11846942.

8. Cooper PR. Traumatic intracranial hematomas. In : Wilkins RH, Rengachary SS, editors. Neurosurgery. New York: McGraw-Hill;vol 2:p. 1657–1661. p. 1985

9. D'Abbondanza JA, Loch Macdonald R. Experimental models of chronic subdural hematoma. Neurol Res. 2014; 36:176–188. PMID: 24172841.

10. D'Errico AP, German WJ. Chronic Subdural Hematoma. Yale J Biol Med. 1930; 3:11–20. PMID: 21433469.

11. Dierckx RA, Bruyland M, Nuyens Z, Stadnik T, Solheid C, Ebinger G. Non-traumatic subdural hygroma. Acta Neurol Belg. 1989; 89:352–357. PMID: 2517182.

12. Ellis H. The Cambridge illustrated history of surgery. Cambridge: Cambridge University Press;2009.

13. Endtz LJ. Post-traumatic hygroma in the eighteenth century: described by Thomas Schwencke. Surg Neurol. 1978; 10:305–307. PMID: 364709.

14. Friede RL, Schachenmayr W. The origin ofsubdural neomembranes. II. Fine structural of neomembranes. Am J Pathol. 1978; 92:69–84. PMID: 686149.

15. Gardner WJ. Traumatic subdural hematoma with particular reference to the latent interval. Arch Neurol Psychiatry. 1932; 27:847–858.

16. Gitlin D. Pathogenesis of subdural collections of fluid. Pediatrics. 1955; 16:345–352. PMID: 13245339.

17. Gross CG. A hole in the head. Neuroscientist. 1999; 5:263–269.

18. Haines DE. On the question of a subdural space. Anat Rec. 1991; 230:3–21. PMID: 2064027.

19. Haines DE, Harkey HL, al-Mefty O. The "subdural" space: a new look at an outdated concept. Neurosurgery. 1993; 32:111–120. PMID: 8421539.

20. Han K, Chen X. The archaeological evidence of trepanation in early China. Indo-Pac Prehist Assoc Bull. 2007; 27:22–27.

21. Hasegawa M, Yamashima T, Yamashita J, Suzuki M, Shimada S. Traumatic subdural hygroma: pathology and meningeal enhancement on magnetic resonance imaging. Neurosurgery. 1992; 31:580–585. PMID: 1407439.

22. Hoff J, Bates E, Barnes B, Glickman M, Margolis T. Traumatic subdural hygroma. J Trauma. 1973; 13:870–876. PMID: 4743143.

23. Ishibashi A, Yokokura Y, Miyagi J. Clinical analysis of nineteen patients with traumatic subdural hygromas. Kurume Med J. 1994; 41:81–85. PMID: 7967442.

24. Ito H, Komai T, Yamamoto S. Fibrinolytic enzyme in the lining walls of chronic subdural hematoma. J Neurosurg. 1978; 48:197–200. PMID: 146730.

25. Ito H, Yamamoto S, Komai T, Mizukoshi H. Role of local hyperfibrinolysis in the etiology of chronic subdural hematoma. J Neurosurg. 1976; 45:26–31. PMID: 132513.

26. Kaufman MH, Whitaker D, McTavish J. Differential diagnosis of holes in the calvarium: application of modern clinical data to palaeopathology. J Archaeol Sci. 1997; 24:193–218.

27. Kawano N, Endo M, Saito M, Yada K. [Origin of the capsule of a chronic subdural hematoma--an electron microscopy study]. No Shinkei Geka. 1988; 16:747–752. PMID: 3412561.

28. Kim DJ. The appeal of holes in the head. In : Whitelaw WA, editor. The Proceedings of the 13th annual history of medicine days. Calgary, CA: Faculty of Medicine;University of Calgary;2004. p. 17–24.

29. Koizumi H, Fukamachi A, Wakao T, Tasaki T, Nagaseki Y, Yanai Y. [Traumatic subdural hygromas in adults--on the possibility of development of chronic subdural hematoma (author's transl)]. Neurol Med Chir (Tokyo). 1981; 21:397–406. PMID: 6165911.

30. Kurin DS. Trepanation in South-Central Peru during the early late intermediate period (ca. AD 1000-1250). Am J Phys Anthropol. 2013; 152:484–494. PMID: 24142537.

31. Lee KS. Natural history of chronic subdural haematoma. Brain Inj. 2004; 18:351–358. PMID: 14742149.

32. Lee KS. The pathogenesis and clinical significance of traumatic subdural hygroma. Brain Inj. 1998; 12:595–603. PMID: 9653522.

33. Lee KS, Bae WK, Bae HG, Yun IG. The fate of traumatic subdural hygroma in serial computed tomographic scans. J Korean Med Sci. 2000; 15:560–568. PMID: 11068995.

34. Lee KS, Bae WK, Park YT, Yun IG. The pathogenesis and fate of traumatic subdural hygroma. Br J Neurosurg. 1994; 8:551–558. PMID: 7857535.

35. Lee KS, Doh JW, Bae HG, Yun IG. Relations among traumatic subdural lesions. J Korean Med Sci. 1996; 11:55–63. PMID: 8703371.

36. Lee KS, Shim JJ, Yoon SM, Doh JW, Yun IG, Bae HG. Acute-on-chronic subdural hematoma: not uncommon events. J Korean Neurosurg Soc. 2011; 50:512–516. PMID: 22323938.

37. Liau LM, Bergsneider M, Becker DP. Pathology and pathophysiology of head injury. In : Youmans JR, editor. Neurological surgery. ed 4. Philadelphia: Saunders;1996. Vol 3:p. 1549–1594.

38. López B, Caro L, Pardiñas AF. Evidence of trepanations in a medieval population (13th-14th century) of northern Spain (Gormaz, Soria). Anthropol Sci. 2011; 119:247–257.

39. Lv X, Li Z, Li Y. Prehistoric skull trepanation in China. World Neurosurg. 2013; 80:897–899. PMID: 23022649.

40. Marino R Jr, Gonzales-Portillo M. Preconquest Peruvian neurosurgeons: a study of Inca and pre-Columbian trephination and the art of medicine in ancient Peru. Neurosurgery. 2000; 47:940–950. PMID: 11014434.

41. Markwalder TM. Chronic subdural hematomas: a review. J Neurosurg. 1981; 54:637–645. PMID: 7014792.

42. Missios S. Hippocrates, Galen, and the uses of trepanation in the ancient classical world. Neurosurg Focus. 2007; 23:E11. PMID: 17961050.

43. Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo). 2001; 41:371–381. PMID: 11561347.

44. Murata K. Chronic subdural hematoma may be preceded by persistent traumatic subdural effusion. Neurol Med Chir (Tokyo). 1993; 33:691–696. PMID: 7505896.

45. Naffziger HC. Subdural fluid accumulations following head injury. J Am Med Assoc. 1924; 82:1751–1752.

46. Naganuma H, Fukamachi A, Kawakami M, Misumi S, Nakajima H, Wakao T. Spontaneous resolution of chronic subdural hematomas. Neurosurgery. 1986; 19:794–798. PMID: 3785628.

47. Ohno K, Suzuki R, Masaoka H, Matsushima Y, Inaba Y, Monma S. Chronic subdural haematoma preceded by persistent traumatic subdural fluid collection. J Neurol Neurosurg Psychiatry. 1987; 50:1694–1697. PMID: 3437306.

48. Oka H, Motomochi M, Suzuki Y, Ando K. Subdural hygroma after head injury. A review of 26 cases. Acta Neurochir (Wien). 1972. 1972; 26:265–273.

49. Oppenheim H. Textbook of nervous diseases for physicians and students. ed 5. New York: Otto Schulze and Company;1911.

50. Panourias IG, Skiadas PK, Sakas DE, Marketos SG. Hippocrates: a pioneer in the treatment of head injuries. Neurosurgery. 2005; 57:181–189. discussion 181-189PMID: 15987554.

51. Park CK, Choi KH, Kim MC, Kang JK, Choi CR. Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma. Acta Neurochir (Wien). 1994; 127:41–47. PMID: 7942180.

52. Park HB, Lee CR, Kim SC. Chronic subdural hematoma superimposed on posttraumatic subdural hygroma: a report of three cases. J Korean Neurosurg Soc. 1990; 19:126–130.

53. Park HR, Lee KS, Shim JJ, Yoon SM, Bae HG, Doh JW. Multiple Densities of the Chronic Subdural Hematoma in CT Scans. J Korean Neurosurg Soc. 2013; 54:38–41. PMID: 24044079.

54. Parlato C, Guarracino A, Moraci A. Spontaneous resolution of chronic subdural hematoma. Surg Neurol. 2000; 53:312–315. discussion 315-317PMID: 10825513.

55. Putnam TJ, Cushing H. Chronic subdural hematoma: its pathology, its relation to pachymeningitis hemorrhagica, and its surgical treatment. Arch Surg. 1925; 11:329–393.

56. Quatrehomme G, Işcan MY. Postmortem skeletal lesions. Forensic Sci Int. 1997; 89:155–165. PMID: 9363624.

57. Rabe EF, Flynn RE, Dodge PR. A study of subdural effusions in an infant. With particular reference to the mechanisms of their persistence. Neurology. 1962; 12:79–92. PMID: 14489575.

58. Rosen HM, Simeone FA. Spontaneous subdural hygromas: a complication following craniofacial surgery. Ann Plast Surg. 1987; 18:245–247. PMID: 3592512.

59. Sankhyan AR, Weber GHJ. Evidence of surgery in Ancient India: trepanation at Burzahom (Kashmir) over 4000 years ago. Int J Osteoarchaeol. 2001; 11:375–380.

60. Sato S, Suzuki J. Ultrastructural observations of the capsule of chronic subdural hematoma in various clinical stages. J Neurosurg. 1975; 43:569–578. PMID: 1181389.

61. Schachenmayr W, Friede RL. The origin of subdural neomembranes. I. Fine structure of the dura-arachnoid interface in man. Am J Pathol. 1978; 92:53–68. PMID: 686148.

62. Seo DH, Lee KS, Shim JJ, Yoon SM. Multiple episodes of hemorrhage identified in MRI of chronic subdural hematomas. Korean J Neurotrauma. 2014; 10:22–25.

63. Sohn IT, Lee KS, Doh JW, Bae HG, Yun IG, Byun BJ. A prospective study on the incidence, patterns and premorbid conditions of traumatic subdural hygroma. J Korean Neurosurg Soc. 1997; 26:87–93.

64. Stone JL, Miles ML. Skull trepanation among the early Indians of Canada and the United States. Neurosurgery. 1990; 26:1015–1019. discussion 1019-1020PMID: 2194137.

65. Sun TF, Boet R, Poon WS. Non-surgical primary treatment of chronic subdural haematoma: preliminary results of using dexamethasone. Br J Neurosurg. 2005; 19:327–333. PMID: 16455539.

66. Taarnhoj P. Chronic subdural hematoma; historical review and analysis of 60 cases. Cleve Clin Q. 1955; 22:150–156. PMID: 13261320.

67. Taguchi Y, Nakamura N, Sato J, Hasegawa Y. [Pathogenesis of chronic subdural hematoma. Sequential study with computerized tomography (author's transl)]. Neurol Med Chir (Tokyo). 1982; 22:276–282. PMID: 6178999.

68. Takahashi Y, Mikami J, Sato H, Takeda S, Matsuoka T, Ito K, et al. [Analysis of chronic subdural hematoma based on CT (Part 2). Symptoms and CT findings (author's transl)]. Neurol Med Chir (Tokyo). 1982; 22:395–401. PMID: 6180342.

69. Trotter W. Chronic subdural hæmorrhage of traumatic origin, and its relation to pachymeningitis hæmorrhagica interna. Br J Surg. 1914; 2:271–291.

70. Tullo E. Trepanation and Roman medicine: a comparison of osteoarchaeological remains, material culture and written texts. J R Coll Physicians Edinb. 2010; 40:165–171. PMID: 20695173.

71. Velasco-Suarez M, Bautista Martinez J, Garcia Oliveros R, Weinstein PR. Archaeological origins of cranial surgery: trephination in Mexico. Neurosurgery. 1992; 31:313–318. discussion 318-319PMID: 1513436.

72. Verano JW. Trepanation in prehistoric South America: geographic and temporal trends over 2000 years. In : Arnott R, Finger S, Smith CUM, editors. Trepanation: history, discovery, theory. Leiden: Swets & Zeitlinger;2003. p. 223–236.

73. Watanabe S, Shimada H, Ishii S. Production of clinical form of chronic subdural hematoma in experimental animals. J Neurosurg. 1972; 37:552–561. PMID: 4627704.

74. Watters DA. Skull trepanation in the Bismarck archipelago. P N G Med J. 2007; 50:20–24. PMID: 19354008.

75. Weigel R, Krauss JK, Schmiedek P. Concepts of neurosurgical management of chronic subdural haematoma: historical perspectives. Br J Neurosurg. 2004; 18:8–18. PMID: 15040710.

76. Weir B. Oncotic pressure of subdural fluids. J Neurosurg. 1980; 53:512–515. PMID: 7420173.

77. Weir B. The osmolality of subdural hematoma fluid. J Neurosurg. 1971; 34:528–533. PMID: 5554357.

78. Wetterling T, Demierre B, Rama B, Nekic M. Protein analysis of subdural hygroma fluid. Acta Neurochir (Wien). 1988; 91:79–82. PMID: 3394551.

79. Whang K, Hu C, Hong SK, Kim HJ, Han YP, Pyen JS. Clinical analysis of chronic subdural hematoma originated from traumatic subdural hygroma. J Korean Neurosurg Soc. 1993; 22:898–904.

80. Wilberger JE. Pathophysiology of evolution and recurrence of chronic subdural hematoma. Neurosurg Clin N Am. 2000; 11:435–438. PMID: 10918012.

81. Yamada H, Nihei H, Watanabe T, Shibui S, Murata S. [Chronic subdural hematoma occurring consequently to the posttraumatic subdural hygroma--on the pathogenesis of the chronic subdural hematoma (author's transl)]. No To Shinkei. 1979; 31:115–121. PMID: 426938.

82. Yamada H, Watanabe T, Murata S, Shibui S, Nihei H, Kohno T, et al. Developmental process of chronic subdural collections of fluid based on CT scan findings. Surg Neurol. 1980; 13:441–448. PMID: 7414475.

83. Yamashima T, Yamamoto S. Clinicopathological classification of chronic subdural hematoma. Zentralbl Neurochir. 1985; 46:304–314. PMID: 3832696.

84. Yoon JW, Park IS, Park H, Kang DH, Park KB, Lee CH, et al. A study of the progression from acute subdural hematoma to chronic stage requiring surgical treatment. Korean J Neurotrauma. 2013; 9:74–80.

85. Zanini MA, de Lima Resende LA, de Souza Faleiros AT, Gabarra RC. Traumatic subdural hygromas: proposed pathogenesis based classification. J Trauma. 2008; 64:705–713. PMID: 18332811.

86. Zollinger R, Gross RE. Traumatic subdural hematoma: an explanation of the late onset of pressure symptoms. J Am Med Assoc. 1934; 103:245–249.