Symptoms and Regional Cerebral Blood Flow in Chronic Subdural Hematoma

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Abstract
Relationship of clinical manifestations to regional cerebral blood flow (r-CBF) was analyzed in 21 adult patients with unilateral chronic subdural hematoma (CSH) before and after operation. The r-CBF was measured by the 133Xe inhalation method and was represented by the initial slope index from Fourier analysis. All the cases showed bilateral decrease in mean hemispheric CBF (mCBF) values, and in 90% of cases the m-CBF values of compressed side by the hematoma were less than or approximately equal to those of contralateral side. The m-CBF values of all the patients with headaches and 56% of cases with neurological deficits stayed within age-matched normal values. The preoperative r-CBF values in the headache group were normal in all detector sites of bilateral hemispheres, while those in the hemiparesis group decreased, especially at the Rolandic motor and sensory area of the hematoma side, which normalized with neurological recovery after hematoma evacuation. In the groups of consciousness disturbance and mental symptom, preoperative r-CBF patterns, which normalized after operation, could be divided as follows: 1) bilateral and total decrease below normal value; 2) no local decrease from the normal value. Some cases showed the relative decrease in r-CBF at a part of frontal lobe. It is suggested that neurological deficits of CSH result from the local circulatory disturbance of blood flow at the brain cortex compressed by hematoma

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