[Acute hematoma between the dura and the external membrane of hematoma capsule of after the removal of bilateral chronic subdural hematomas by trepanation. Case report]. / Ostry krwiak miedzy opona twarda a zewnetrzna torebka krwiaka w przebiegu pooperacyjnym usuniecia obustronnych przewleklych krwiaków podtwardówkowych droga trepanacji. Opis przypadku.

A case of reported of complication following surgical treatment of bilateral subdural haematomas in an elderly man. Acute haematoma developed after the operation between the dura and the external surface of the capsule of the haematoma which had been removed several hours earlier through a trepanation hole. Attention is called to the atypical localization of the complication with bleeding externally to the capsule and not into the space left after haematoma evacuation which is usually observed in case of haematoma recurrence. The problem is discussed, whether such bleeding during chronic persistence of haematoma can lead to the development of multilayer and multilocular haematomas. In the presented case quick recognition of the complication followed by reoperation with removal of haematoma and bleeding capsule through craniotomy with rehabilitation treatment after the operation has led to very good therapeutic effect.

[Diagnostic and therapeutic difficulties in a case of severe craniocerebral injury caused by an electric injury and a fall]. / Trudnosci diagnostyczne i lecznicze w przypadku ciezkiego urazu czaszkowo-mózgowego spowodowanego razeniem pradem elektrycznym i upadkiem z wysokosci

The authors describe a 37-year-old man suffering electric shock caused by high-voltage current 3 000 Volt. The shock caused a fall with severe craniocerebral injury with fracture of occipital squama and subacute epidural haematoma in the posterior cerebral fossa. The injury was associated with vascular disturbances of the brain and brain stem which caused difficulties in disclosing typical signs of epidural heaematoma. Good therapeutic effects were obtained not only by surgical intervention and also by intensive treatment with antioedematous agents and drugs improving cerebral circulation.

[Diagnosis of 3-level lumbar nucleus pulposus prolapse]. / Diagnostyka trójpoziomowej przepukliny jadra miazystego tarcz miedzykregowych Kregoslupa

Clinical investigations and plain film of the spine are not sufficient for diagnosis of three-level lumbar nucleus pulposus prolapse. Contrast investigations, especially radiculography with television monitoring, are particularly suitable for demonstration of multiple prolapses. In a material of 730 cases two-level prolapse was found in about 12% of cases and three-level prolapse in about 0.5% of cases and this suggests that radiculography should be carried out routinely before each operation for lumbar nucleus pulposus prolapse.

[Clinical picture of medial prolapse of a lumbar intervertebral disk]. / Obraz kliniczny srodkowej przepukliny jadra miazdzystego ledzwiowego odcinka kregoslupa.

Case records of one-hundred patients operated on for centrally prolapsed lumbar intervertebral disc were analyzed for establishing of typical clinical symptom complex. Despite the complexity and variety of clinical manifestations five groups of patients were isolated on the basic of their pain features and neurological deficit. Besides, for more exact diagnosis of prolapsed level, the neurological signs were analyzed in relation to these levels. This approach makes possible more precise diagnosis in practice important in view of the possible consequences of central prolapsed of intervertebral disc (PIVD).