Addis Ababa University, school of medicine, Addis Ababa, Ethiopia.
BMC Endocr Disord. 2022 Jan 12;22(1):6. doi: 10.1186/s12902-021-00916-1.
While both DKA & CSDH/subdural hygroma/ are known to cause significant morbidity and mortality, there is no a study that shows the role & effect of DKA on CSDH/subdural hygroma/ & vice versa to authors' best knowledge; hence this work will show how important relation does exist between DKA & CSDH/ hygroma. This study highlights the diagnostic & management challenges seen for a case of a 44 years old female black Ethiopian woman admitted with a diagnosis of newly diagnosed type 1 DM with DKA + small CSDH/subdural hygroma/ after she presented with sever global headache and a 3 month history of lost to her work. She needed burrhole & evacuation for complete clinical improvement besides DKA's medical treatment.
DKA induced cerebral edema on the CSDH/subdural hematoma/ can have a role in altering any of the parameters (except the thickness of CSDH) for surgical indication of patients with a diagnosis of both CSDH +DM with DKA. Hence, the treating physicians should be vigilant of different parameters that suggests tight brain &/ cerebral edema (including midline shift, the status of cisterns, fissures & sulci) and should not be deceived of the thickness of the CSDH/subdural hygroma/alone; especially when there is a disproportionately tight brain for the degree of collection. Whether DKA induced cerebral edema causes a subdural hygroma is unknown and needs further study.
虽然 DKA 和 CSDH/硬脑膜下水肿/都已知会导致显著的发病率和死亡率，但据作者所知，尚无研究表明 DKA 对 CSDH/硬脑膜下水肿/的作用和影响，反之亦然；因此，这项工作将表明 DKA 和 CSDH/硬脑膜下水肿/之间确实存在着重要的关系。本研究强调了诊断和管理方面的挑战，研究对象是一名 44 岁的黑人埃塞俄比亚女性，她被诊断为新发 1 型糖尿病合并 DKA 和小的 CSDH/硬脑膜下水肿/，因为她出现了严重的全头痛，并且有 3 个月的旷工史。她需要接受颅骨钻孔和清除术才能完全改善临床症状，同时还需要治疗 DKA。
DKA 引起的硬脑膜下血肿脑水肿可能在改变诊断为 CSDH + DKA 的患者的手术指征的任何参数（除了硬脑膜下血肿的厚度外）中发挥作用。因此，治疗医生应该警惕提示紧密的脑和/或脑水肿的不同参数（包括中线移位、脑池状态、脑裂和脑沟），而不应该仅仅被硬脑膜下血肿的厚度所欺骗；特别是当存在与血肿程度不成比例的紧密脑时。DKA 引起的脑水肿是否会导致硬脑膜下水肿尚不清楚，需要进一步研究。
