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Indian Journal of Neurotrauma 2014; 11(02): 146-149
DOI: 10.1016/j.ijnt.2014.05.003
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Spontaneous resolution of traumatic acute subdural hematoma with good clinical outcome: A report of two cases

Vinay Byrappa
a   Senior Resident, Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
,
Sonia Bansal
b   Assistant Professor, Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
,
Sriganesh Kamath
c   Associate Professor, Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
,
Gopala Krishna N. Kadarapura
b   Assistant Professor, Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
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Publication History

04 April 2014

12 May 2014

Publication Date:
06 April 2017 (online)

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Abstract

Post-traumatic acute subdural hematoma (ASDH) requires immediate surgical evacuation in most cases. We present two cases of ASDH which resolved spontaneously. The first patient had 9 mm thick ASDH in left fronto-temporo-parietal region with initial GCS of E1V1M3 which improved to E2VtM4 within 7 h. Repeat CT of the brain showed a decrease in the size of ASDH. Hence, patient was conservatively managed with anti-edema measures and elective ventilation. The patient improved and ASDH also resolved completely. The second patient also had 8 mm thick ASDH in the right fronto-temporo-parietal region with GCS of E1V2M5 which 5 h later improved to E3V4M5. With conservative measures, there was clinical and radiological improvement. Based on previous reports, certain characteristic features have been shown to favor spontaneous resolution of ASDH; absence of underlying contusion and the presence of a low-density band between the skull and the hematoma on imaging were features common to our patients also.

Keywords

Acute subdural hematoma - Spontaneous resolution - Non-surgical management of acute SDH
 

  • References

  • 1 Seelig J.M., Becker D.D., Miller J.D., Greenberg R.P., Ward J.D., Choi S.C.. Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours. N Engl J Med 1981; 304: 1511-1518
    CrossrefPubMedGoogle Scholar
  • 2 Kelly D.F., Wikas D.L., Becker D.P.. Diagnosis and treatment of moderate and severe head injuries in adults. Youmans: Neurological Surgery. 4th ed.. 1996. Saunders; Philadelphia: 1618-1718
    Google Scholar
  • 3 Fujimoto K., Otsuka T., Yoshizato K., Kuratsu J.. Predictors of rapid spontaneous resolution of acute subdural hematoma. Clin Neurol Neurosurg 2014; 118: 94-97
    CrossrefPubMedGoogle Scholar
  • 4 Edwards R.J., Britz G.W., Critchley G.R.. Spontaneous resolution of an acute subdural haematoma. Br J Neurosurg 2002; 16: 609-610
    CrossrefPubMedGoogle Scholar
  • 5 Kapsalaki E.Z., Machinis T.G., Robinson 3rd J.S., Newman B., Grigorian A.A., Fountas K.N.. Spontaneous resolution of acute subdural hematomas. Clin Neurol Neurosurg 2007; 109: 287-291
    CrossrefPubMedGoogle Scholar
  • 6 Mirzai H., Yaldiz C., Eminoglu M., Orguc S.. Neurological picture. Ultra-fast resolution of acute post traumatic subdural hematoma. J Neurol Neurosurg Psychiatry 2005; 76: 1738
    CrossrefPubMedGoogle Scholar
  • 7 Wu M.C., Liu J.X., Luo G.C.. et al Rapid natural resolution of intracranial hematoma. Chin J Traumatol 2004; 07: 96-100
    PubMedGoogle Scholar
  • 8 Polman C.H., Gijsbers C.J., Heimans J.J.. et al Rapid spontaneous resolution of an acute subdural hematoma. Neurosurgery 1986; 19: 446-448
    CrossrefPubMedGoogle Scholar
  • 9 Kundra S.N., Kundra R.. Extracranial redistribution causing rapid spontaneous resolution of acute subdural hematoma. Neurol India 2005; 53: 124
    CrossrefPubMedGoogle Scholar
  • 10 Wen L., Liu W.G., Ma L., Zhan R.Y., Li G., Yang X.F.. Spontaneous rapid resolution of acute subdural hematoma after head trauma: is it truly rare. Ir J Med Sci 2009; 178: 367-371
    CrossrefPubMedGoogle Scholar