Deep burns of the scalp and skull can be caused by high-voltage electrical injuries. Electrocution can occur while working and illegal handling of the lines. Compared to conventional burns, these injuries are characterized by an increased morbidity and mortality. We encountered an unusual case of high-voltage electrical burn of the head causing charring of scalp, bone and dura with herniation of infected brain matter.
ABSTRACT:We report a case of a 47 year old man who presented with head injury due to road traffic accident, with CT scan suggestive of large left sided acute SDH with comminuted fracture of occipital bone. Within a few hours, patient showed significant neurological improvement. Follow-up CT scan revealed rapid spontaneous resolution and redistribution of the acute SDH. The proposed hypothesis explaining this rare phenomenon suggests intracranial and extra cranial redistribution as the cause of spontaneous resolution of acute SDH. The intracranial phenomenon is more common of the two. To our knowledge, this is the first case in the literature where both intracranial and extracranial phenomenon played a role in the same patient leading to rapid spontaneous resolution of acute SDH. KEY WORDS: • acute subdural hematoma • spontaneous resolution • intracranial redistribution • extracranial redistribution.
INTRODUCTION:Acute subdural hematoma (SDH) is a common entity after traumatic brain injury. Acute SDH, more than 10mm in thickness, require immediate surgical evacuation in vast majority of the cases. Though a very rare phenomenon, rapid spontaneous resolution of acute SDH does occur 1,2,3,4,5,6,7 . Two possible hypotheses have been suggested: (1) the hematoma is diluted by cerebrospinal fluid (CSF) due to tearing of the arachnoid membrane and then is washed out. (2) The hematoma is compressed by the pressure produced by acute brain swelling and is redistributed 4 . In our current communication, we present a case of spontaneous resolution of acute SDH, the proposed theories explaining spontaneous resolution of acute SDH, as well as, the clinical parameters and imaging characteristics that might predict such a phenomenon are also reviewed. The possibility of spontaneous resolution of an acute SDH, although remote, may affect the decision making process regarding the management of these patients under certain conditions 1 .
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.