Case report on the spontaneous resolution of a traumatic intracranial acute subdural haematoma: evaluation of the guidelines

Hostettler, Isabel C.; Murahari, Srinivas; Raza, Muhammad Hasan; Kontojannis, Vassilios; Tsang, Kevin; Kareem, Haider; Jones, Brynmor; Wilson, Mark

doi:10.1007/s00701-018-3556-2

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…In some cases, neurological condition remained stable [8,10,17,21,28,33] or improved gradually [12,15,16,18,19,24,29,35] The death of one such patient reported by Balik et al had been correlated with hemodynamic instability and sudden cardiac arrest due to sympathetic hyperactivity. On postmortem examination of the above case, redistribution of hematoma in spinal subdural space and ischemic changes in the pons was detected.…”

Section: Predicting Spontaneous Rapid Resolution Of Acute Subdural He...mentioning

confidence: 98%

“…In some cases, neurological condition remained stable[ 8 10 17 21 28 33 ] or improved gradually[ 12 15 16 18 19 24 29 35 ] The death of one such patient reported by Balik et al . had been correlated with hemodynamic instability and sudden cardiac arrest due to sympathetic hyperactivity.…”

Section: Predicting Spontaneous Rapid Resolution Of Acute Subdural Hematomamentioning

confidence: 99%

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Rapid spontaneous resolution of the acute subdural hematoma: Case series and review of literature

Rathore¹,

Sahana²,

Kumar³

et al. 2021

Asian J Neurosurg

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Background: Traumatic acute subdural hematoma (ASDH) is an oft encountered entity in neurosurgery. While resolution of such thick SDHs usually takes time, certain cases of rapid spontaneous resolution have also been reported. This article attempts to review the pathophysiology, clinical and radiological features of such cases, as well as provide an insight into decision making for their management. Methods: Electronic literature search was done to look for similar cases of spontaneous rapid resolution of ASDH. Five of authors cases have been described. Their clinical and radiological features along with those of cases from literature search were tabulated and analyzed. Results: A total of 44 relevant cases were included for analyses. Of these, 39 cases were from 33 articles found in existing literature and 5 cases were from author's collection. The M:F ratio was 25:19 with a mean age was 41.84(SD-4.094) years. Twenty -six patients showed “Rapid” neurological improvement (24 hours) occurred in 10 patients. The mean hematoma resolution time on CT scan was 13.78 hours (SD 16.46) ranging from 1- 72 hours. Twenty-nine patients showed redistribution of hematoma, most commonly to tentorium and falx cerebelli. CT scan findings were classified into 5 types as per the nature of hypodensity around hematoma. The geometric mean time to resolution of hematoma was least for type 2 (7.27 hours) and type 1(7.52 hours) patients. Conclusion: Selected patients of ASDH with rapid neurological improvement and specific CT findings may show spontaneous resolution of ASDH. Multicentric studies with larger study population may provide better insight into the nature and outcomes of such entities.

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Section: Predicting Spontaneous Rapid Resolution Of Acute Subdural He...mentioning

confidence: 98%

Section: Predicting Spontaneous Rapid Resolution Of Acute Subdural Hematomamentioning

confidence: 99%

Rapid spontaneous resolution of the acute subdural hematoma: Case series and review of literature

Rathore¹,

Sahana²,

Kumar³

et al. 2021

Asian J Neurosurg

View full text Add to dashboard Cite

show abstract

“…After then sporadic case reports were continued until recent years. 1 2 7 9 10 14 16 17 19) Öğrenci et al 15) summarized total 12 pediatric cases from 1986 to 2015. Fujimoto et al 7) analyzed 18 patients of rapid spontaneous resolution of ASDH between 2006 and 2012.…”

Section: Discussionmentioning

confidence: 99%

“…So called “low-density band” between ASDH and skull seen in CT scan suggests such CSF collection. 2 3 4 5 6 7 8 9 10 11 12 13 16 17 19 20) 2) Redistribution of hematoma to another space; contralateral intracranial space, intradiploic space and/or subgaleal space through the skull fracture, spinal subdural space, by raised pressure caused by brain swelling, other intracranial hemorrhages, and/or subdural hematoma itself. 1 3 4 5 6 7 8 9 10 11 12 13 14 16 17 19 20) It has been claimed also that brain atrophy leads to widening of subarachnoid space, which facilitates the removal of ASDH by aiding the redistribution of the hematoma.…”

Section: Discussionmentioning

confidence: 99%

“… 2 3 4 5 6 7 8 9 10 11 12 13 16 17 19 20) 2) Redistribution of hematoma to another space; contralateral intracranial space, intradiploic space and/or subgaleal space through the skull fracture, spinal subdural space, by raised pressure caused by brain swelling, other intracranial hemorrhages, and/or subdural hematoma itself. 1 3 4 5 6 7 8 9 10 11 12 13 14 16 17 19 20) It has been claimed also that brain atrophy leads to widening of subarachnoid space, which facilitates the removal of ASDH by aiding the redistribution of the hematoma. 1 5 8 12 13 19) Lee et al 12) suggest that the expanded subarachnoid space due to brain atrophy can be a favorable factor which could affect the dilution and redistribution of the hematoma.…”

Section: Discussionmentioning

confidence: 99%

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Rapid Spontaneous Resolution of Large Acute Subdural Hematoma

Kwon

Hwang

Shin

2021

Korean J Neurotrauma

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Usually, acute subdural hematomas (ASDHs) result from head trauma and require urgent surgical treatment. However, there have been many reports of rapid spontaneous resolution of ASDHs since 1986. Recently, we experienced a case of a massive ASDH that resolved spontaneously within 1.5 days. A 76-year-old man was admitted to a local hospital after a head injury. According to his clinical records, his initial neurologic status was good (Glasgow Coma Scale score of 14). However, his head computer tomography (CT) scan demonstrated a massive ASDH to the right, with a significant midline shift. Based on his neurological status and general condition, surgery was not considered, and the patient was closely monitored in the intensive care unit. The next day, the patient was transferred to our hospital as requested by his family, after which his neurological state stabilized, and the customary follow-up brain CT was performed. It was about 32 hours after the patient's head injury, and it revealed an unexpected finding, near-total resolution of the ASDH. Herein, we review previously reported similar cases and relevant mechanisms of rapid resolution of the ASDH. We believe that neurosurgeons should comprehensively assess the patient's condition and CT findings and provide appropriate treatment, especially when surgical intervention is unnecessary.

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Rapid absorption of frontal lobe contusion and laceration with hematoma: A case report and review of literature

Liu

Lin

et al. 2023

Medicine

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Rationale: It is rare for a traumatic intracranial hematoma to self-absorb rapidly after conservative treatment. To the best of our knowledge, there has been no report in the relevant literature of rapid absorption of hematoma formation following cerebral contusion and laceration. Patient concerns: A 54-year-old male was admitted to our hospital with head trauma at 3 hours prior to admission. He was alert and oriented, glasgow coma scale score of 15. Head computed tomography (CT) showed left frontal brain contusion with hematoma, however, a reexamination of CT about 29 hours following the trauma revealed that the hematoma had been absorbed. Diagnoses: A diagnosis of contusion and laceration of left frontal lobe with hematoma formation was made based on the CT images. Interventions: The patient underwent conservative treatment. Outcomes: After treatment, dizziness and headache subsided for the patient, and no special discomfort was reported. Lessons: It is likely that the reason for rapid absorption in this case is that the hematoma is prone to liquefaction because of abnormal platelet values and coagulation dysfunction. As the liquefaction hematoma breaks into the lateral ventricle, it is redistributed and absorbed in the lateral ventricle and subarachnoid space. Further evidence is required to support this hypothesis.

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Case report on the spontaneous resolution of a traumatic intracranial acute subdural haematoma: evaluation of the guidelines

Cited by 4 publications

References 24 publications

Rapid spontaneous resolution of the acute subdural hematoma: Case series and review of literature

Rapid spontaneous resolution of the acute subdural hematoma: Case series and review of literature

Rapid Spontaneous Resolution of Large Acute Subdural Hematoma

Rapid absorption of frontal lobe contusion and laceration with hematoma: A case report and review of literature

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