Rapid resolution of acute epidural hematoma: case report and review of the literature

Rapid Spontaneous Resolution of Acute Epidural Hematoma: A Case Report and Review of the Literature

“…Aoki et al (2) reported that skull fracture has a positive impact on prognosis as it provides a connection between the epicranial and epidural spaces. Two EDH cases with fractures including the external auditory canal have been published in the literature and rapid spontaneous resolution without an increase in intracranial pressure was reported (5,8). However, Gülşen et al (9) reported a 4 year-old with a case of spontaneous resolution without skull fracture.…”

“…Fifteen cases have been reported in the literature with a resolution less than 24 hours, including our case; these are summarized in Table 1 (2)(3)(4)(5)(6)(7)(8)(9). Of the patients, ten were pediatric (under age 18) and five were adults.…”

Spontaneous Decompression of Extradural Hematoma Through Skull Fracture

“…Spontaneous resolution of EDH has been reported in all age groups. 5,9,14 Usually, the spontaneous resolution takes place in weeks and rarely in days, 2-4,9,14-16 but in rare circumstances the EDH can resolve within hours after trauma. 5,[8][9][10]14,17,18 The mechanisms responsible for the spontaneous resolution of the EDH in acute stage are entirely different than that of chronic resolution.…”

“…5,9,14 Usually, the spontaneous resolution takes place in weeks and rarely in days, 2-4,9,14-16 but in rare circumstances the EDH can resolve within hours after trauma. 5,[8][9][10]14,17,18 The mechanisms responsible for the spontaneous resolution of the EDH in acute stage are entirely different than that of chronic resolution. 5,9,14,[17][18][19] The mechanism behind chronic resolution of EDH is that there is formation of fibrovascular neomembrane and granulation tissue, acting as a semipermeable membrane like absorbing structure through which there is transfer of the clot into diploic bone or extracranial space through the fractures.…”

“…It has been estimated that acute epidural hematoma (EDH) accounts for 1.5% of patients treated for traumatic brain injury and the lesion can be potentially fatal, and urgent surgical intervention is recommended. [1][2][3][4][5][6][7] However, it has been increasingly recognized that there is a subgroup of patients, where the EDH disappeared rapidly without surgical evacuation. 1,4,5,[8][9][10][11][12][13] In present article, we report a case of an elderly gentleman whose follow-up computed tomography (CT) scan showed reduction in the size of acute EDH and review the relevant literature.…”