{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:01:36Z","timestamp":1785942096565,"version":"3.56.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"19","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>\n                    Subdural hematomas (SDHs) are increasingly common and can cause ischemic brain injury. Previous work has suggested that this is driven largely by vascular compression from herniation, although this work was done before the era of magnetic resonance imaging (MRI). We thus sought to study SDH-related ischemic brain injury by looking at patterns of cytotoxic edema on diffusion-weighted MRI. To do so, we identified all SDH patients at a single institution from 2015 to 2019 who received an MRI within 2 weeks of presentation. We reviewed all MRIs for evidence of restricted diffusion consistent with cytotoxic edema. Cases were excluded if the restricted diffusion could have occurred as a result of alternative etiologies (e.g., cardioembolic stroke or diffuse axonal injury). We identified 450 SDH patients who received an MRI within 2 weeks of presentation. Twenty-nine patients (\u223c6.5% of all MRIs) had SDH-related cytotoxic edema, which occurred in two distinct patterns. In one pattern (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u2009=\u20099), patients presented as comatose with severe midline shift and were found to have cytotoxic edema in the vascular territories of the anterior and posterior cerebral artery, consistent with herniation-related vascular compression. In the other pattern (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u2009=\u200919), patients often presented as awake with less midline shift and developed cytotoxic edema in the cortex adjacent to the SDH outside of typical vascular territories (peri-SDH cytotoxic edema). Both patterns occurred in 1 patient. The peri-SDH cytotoxic edema pattern is a newly described type of secondary injury and may involve direct toxic effects of the SDH, spreading depolarizations, or other mechanisms.\n                  <\/jats:p>","DOI":"10.1089\/neu.2021.0125","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T02:49:11Z","timestamp":1623293351000},"page":"2677-2685","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Diffusion-Weighted Imaging Reveals Distinct Patterns of Cytotoxic Edema in Patients with Subdural Hematomas"],"prefix":"10.1177","volume":"38","author":[{"given":"David","family":"Robinson","sequence":"first","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Kreitzer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura B.","family":"Ngwenya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA."},{"name":"Collaborative for Research on Acute Neurological Injuries, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Opeolu","family":"Adeoye","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Washington University, St. Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jed","family":"Hartings","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA."},{"name":"Collaborative for Research on Acute Neurological Injuries, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Foreman","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA."},{"name":"Collaborative for Research on Acute Neurological Injuries, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-016-0279-1"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.117655"},{"key":"e_1_3_5_4_2","first-page":"1","article-title":"The epidemiology of intracerebral hemorrhage, in Intracerebral Hemorrhage","author":"Flaherty M.","year":"2010","unstructured":"Flaherty M., , Woo D., , and Broderick J. 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