Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood

Gülşen, İsmail; Ak, Hakan; Sosuncu, Enver; Yavuz, Alpaslan; Kıymaz, Nejmi

doi:10.1155/2013/956849

Cited by 5 publications

(9 citation statements)

References 13 publications

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“…The initial cases of spontaneous resolutions of epidural hematomas were described by Weaver et al . [ 3 ] The literature research reveals nine pediatric cases[ 4 5 ] and five adult cases. [ 6 ] The oldest patient reported in the literature was 65 years.…”

Section: Discussionmentioning

confidence: 99%

“…Site and side Age/sex Skull fracture Year Time to resorption Aoki [9] Left temporal 17/male Yes 1988 5 h F. Servadei Right parietal 65 years/male Yes 1989 Unknown H. Dolgun Right temporal 27 years/male Yes 2011 3 h Kang et al [10] Bilateral posterior fossa resolution of a 60 ml epidural hematoma. The initial cases of spontaneous resolutions of epidural hematomas were described by Weaver et al [3] The literature research reveals nine pediatric cases [4,5] and five adult cases. [6] The oldest patient reported in the literature was 65 years.…”

Section: Authorsmentioning

confidence: 99%

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Spontaneous resolution of epidural hematoma: A rare case

et al. 2019

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An epidural hematoma is a life-threatening condition which necessitates early surgical intervention. Conservative management is undertaken in smaller hematomas; rarely, a massive hematoma may show spontaneous resolution which can be picked up only by a repeat computed tomography before surgery. Here, we report one such case where we noted a surprisingly rapid resolution of an epidural hematoma, which was relatively a large clot and where the last minute call to have a repeated computed tomography scan changed the line of management altogether from a surgical one to conservative. The patient in this particular case is a 20-year-old male, with a history of fall from height. The initial scan showed a large epidural hematoma which requires surgical evacuation, whereas the subsequent scans showed near-complete resolution and hence was managed conservatively. Rare cases like these should always be kept in mind, and the importance of a repeat scan should never be disregarded.

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Section: Discussionmentioning

confidence: 99%

Section: Authorsmentioning

confidence: 99%

Spontaneous resolution of epidural hematoma: A rare case

et al. 2019

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“…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.…”

Section: Discussionmentioning

confidence: 92%

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

et al. 2016

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Background: Epidural hematomas (EDH) are pathologies in which the early diagnosis and treatment are important. Resolution under 24 hours is very rare. Case Report: An 11-month-old male patient was brought to the emergency department with head trauma from falling out of bed onto his back. There were no neurological deficits, except for the patient being somnolent. Computed tomography (CT) of the patient revealed subgaleal edema in the right parietal region, linear fracture and image consistent with EDH with a thickness of about 9 mm underneath fracture. A control CT was performed after 3 hours as somnolence continued in follow-up of the patient. Hematoma in the epidural region was observed to completely resolve and edema in the subgaleal region was observed to gain hemorrhagic characteristics. Conclusion: In total, 15 cases have been reported, including our case, in the literature with resolution less than 24 hours. Our case has the fourth fastest resolution ever reported in the English literature. We think that the most important factor in the rapid spontaneous resolution is the presence of a connection between the epidural and epicranial space, either through a fracture or cranial sutures

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“…The longer time course of days as seen in our patient suggests a different mechanism of resolution. Possible open cranial sutures may explain spontaneous resolution of EDH in cases without fractures [12]. The young age and clinical course of our patient make this mechanism a possibility.…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, spontaneous resolution of epidural hematomas treated conservatively in the absence of surgical intervention is a rare occurrence in both pediatric and adult populations. Since 1981, there have been only 9 documented cases of spontaneously resolving epidural hematomas in the adult population, with all of these cases involving cranial epidural hematomas and all resolving within 72 h. In all but 1 of these cases, the patient also sustained a skull fracture, suggesting the possibility of spontaneous resolution due to blood leaking through open fracture lines [12,13,14,15]. Conservative management of patients with spontaneous spinal epidural hematomas is not routinely recommended as emergency surgical intervention is often required.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Resolution of Spinal Epidural Hematoma Resulting from Domestic Child Abuse: Case Report

Rangwala¹,

Birk²,

Tobin³

et al. 2016

Pediatr Neurosurg

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Nonaccidental head injury, as seen in domestic child abuse cases, is often associated with spinal injury, and spinal subdural hematoma is the most frequent diagnosis. While spinal epidural hematomas are a rare occurrence, the incidence of spontaneous epidural hematomas occurring in nonaccidental head injury patients is even lower. Epidural hematomas often result in acute focal neurological deficits necessitating emergent neurosurgical intervention. In patients without focal neurological deficits, conservative management may allow for spontaneous resolution of the epidural hematoma. The authors present the case of a 2-year-old boy with a large spinal epidural hematoma resulting after an event of nonaccidental injury, specifically, domestic child abuse. This patient exhibited no focal neurological deficits and was managed conservatively without surgical clot evacuation. On a follow-up visit, repeat imaging studies demonstrated a stable resolution of spinal epidural hematoma, providing further support for the safety of conservative management in these patients.

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Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood

Cited by 5 publications

References 13 publications

Spontaneous resolution of epidural hematoma: A rare case

Spontaneous resolution of epidural hematoma: A rare case

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

Spontaneous Resolution of Spinal Epidural Hematoma Resulting from Domestic Child Abuse: Case Report

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