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History of Chronic Subdural Hematoma
#MMPMID27169062
Lee KS
Korean J Neurotrauma
2015[Oct]; 11
(2
): 27-34
PMID27169062
show ga
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.
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