engleski

Post-traumatic hydrocephalus: the role of tears of the choroid tela and plexus as a source of intraventricular bleeding

Hydrocephalus belongs to very frequent sequels of closed head trauma. Contrary to some previous hypotheses of an "ex vacuo" mechanism of such hydrocephalus, the authors' investigations strongly suggest that arachnoidal adhesions due to subarachnoidal suffusion of blood are responsible for this phenomenon. According to previous report of one of the authors (8), tela chorioidea of the third and lateral ventricles, as the most delicate one of the midline structures, is frequently damaged in closed brain injury and represents the most frequent lesion within the pattern of "inner cerebral trauma". Authors' preliminary observations suggested that even in cases with minimal blows, but sufficient to cause considerable linear translation of acceleration, tears of the telas may occur and cause an intraventricular bleeding, which spreads with the CSF into the subarachnoidal space producing a reaction leading to impairment of the CSF absorption and "normal pressure hydrocephalus". On the basis of 35 new and carefully examined cases, the authors present new evidence for such a phenomenon and mechanism of hydrocephalus. According to these correlative investigations, the telas and the plexus are indeed a critical point as a source of intraventricular bleeding, which may be overlooked in the acute "brain concussion", but might cause a serious complication in the form of "normal pressure hydrocephalus".

hydrocephalus; brain injury; intraventricular hemorrhage; choroid tela and plexus

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