[Subdural hematoma from @entity397 -mechanism of XXXX in minor @entity542 ].

@entity1 @entity3439 @entity64 @entity101 @entity510 @entity542 @entity772 @entity909 @entity1010 @entity397 @entity10 @entity204 @entity2849 @entity4288
Five cases of @entity3439 from @entity397 (SDH-AR) are described and other 39 reported cases are reviewed. The average age of the @entity1 is 59 and male to female ratio is 2:1. Fifty two percent of the @entity1 have history of recent @entity542 most of which are trivial. A very few @entity1 have @entity909 . Approximately half of the @entity1 with history of @entity542 have long lucid interval (average of 7 days). Those @entity1 without history of @entity542 have spontaneous onset of the symptoms and some of the have acute onset of @entity10 and @entity909 , simulating @entity64 . Natural history of the SDH-AR is progressing deterioration of the symptoms, resulting in @entity772 and @entity204 . Skull fracture is seldom demonstrated in the @entity1 with SDH-AR. Angiography shows and extracerebral avascular mass over the cerebral convexity with marked midline shift. In 3 cases including our 2 cases, extravasation of the contrast medium from the cortical artery is observed and this is a useful finding for making diagnosis of this disease. Computerized tomography reveals high density extracerebral mass with remarkable mass effect. Craniotomy discloses subdural clot and spurting @entity397 from a branch of the cortical artery around the Sylvian fissure. In some cases, @entity510 is observed but in none of the cases, cerebral contusion or laceration is present. It is presumed that the mechanism of the @entity397 is gliding movement of the brain within the skull upon injury, tearing an arterial twig with dural attachment. @entity101 , @entity4288 and @entity1010 may be important contributing factors to this mechanism. @entity2849 caused by closed @entity542 is also associated with this mechanism and may explain delayed sudden onset of the symptoms in some @entity1 with SDH-AR.
