title: Subdural hematoma decompression model: A model of traumatic brain injury with ischemic-reperfusional pathophysiology: A review of the literature.
abstract: The prognosis for patients with traumatic brain injury (TBI) with subdural hematoma (SDH) remains poor. In accordance with an increasing elderly population, the incidence of geriatric TBI with SDH is rising. An important contributor to the neurological injury associated with SDH is the ischemic damage which is caused by raised intracranial pressure (ICP) producing impaired cerebral perfusion. To control intracranial hypertension, the current management consists of hematoma evacuation with or without decompressive craniotomy. This removal of the SDH results in the immediate reversal of global ischemia accompanied by an abrupt reduction of mass lesion and an ensuing reperfusion injury. Experimental models can play a critical role in improving our understanding of the underlying pathophysiology and in exploring potential treatments for patients with SDH. In this review, we describe the epidemiology, pathophysiology and clinical background of SDH.
authors.affiliation: Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan. Electronic address: shoji@nms.ac.jp.
authors.forename: Shoji
authors.initials: S
authors.lastname: Yokobori
authors.affiliation: Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Nakae
authors.affiliation: Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokota
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Markus S
authors.initials: MS
authors.lastname: Spurlock
authors.affiliation: Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Mondello
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Gajavelli
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Ross M
authors.initials: RM
authors.lastname: Bullock
mesh_terms: D000818:Animals; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D056424:Decompressive Craniectomy; D004195:Disease Models, Animal; D006408:Hematoma, Subdural / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D051381:Rats; D015427:Reperfusion Injury / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*
keywords: Decompressive craniotomy; Ischemic/reperfusional brain injury; Subdural hematoma; Therapeutic hypothermia; Traumatic brain injury