Das Subdurale Hämatom Und Die Pachymeningitis Haemorrhagica Interna
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Die nosologischen Beziehungen zwischen den subduralen Blutungen trauma- tischer Genese und den Durablutungen auf dem Boden entzündlicher oder degenerativer Veränderungen der harten Hirnhaut sind bisher noch nicht endgültig geklärt. Ähnlichkeiten des morphologischen Bildes und der klinischen Erscheinun- gen bringen es mit sich, da die Bezeichnungen "subdurales Hämatom" und "Pachymeningitis haemorrhagica interna" vielfach synonym gebraucht werden. Dabei werden von manchen Autoren zwei pathogenetisch verschiedene, klinisch und auch pathologisch-anatomisch jedoch nicht ausreichend unterscheidbare Krankheitsbilder angenommen. Andere Bearbeiter meinen, da in allen Fällen eine einheitliche Pathogenese gegeben sei und verneinen dann je nach ihrer Ein- stellung entweder die Existenz einer Pachymeningitis haemorrhagica interna sui generis oder die eines traumatisch bedingten subduralen Hämatoms. Schlie lich wird auch die Auffassung vertreten, da eine klare Unterscheidung zwischen traumatischem subduralen Hämatom und Pachymeningitis haemorrhagica zum wenigsten auf Grund des morphologischen Befwldes möglich sei und auch klinisch eine weitgehende Trennung angestrebt werden müsse. Die bisher noch bestehenden Unklarheiten machen es erforderlich, immer wieder die klinischen und pathologisch-anatomischen Befunde zu überprüfen und miteinander zu vergleichen. In dieser Arbeit soll untersucht werden, wieweit klinische Beobachtungen zu einer Klärung der Probleme beitragen können. Dabei ist besonders zu fragen, ob sich fest umrissene Krankheitsbilder erarbeiten lassen, die dem einen oder anderen morphologischen Befund zugeordnet werden können und ob weiterhin die klinischen Gegebenheiten irgendwelche Rückschlüsse auf Syndromgenese und Pathogenese zulassen.
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