Rapid Resolution of Acute Subdural Hematoma

Abstract

We report four cases of acute subdural hematoma (ASDH) in which the hematoma rapidly resolved. Three of the four hematomas were traumatic. The outcome was good in three cases and fair in one. Spontaneous resolution of ASDH is rare.

Rapid Spontaneous Resolution of Acute Subdural Hematoma Occurs by Redistribution. Two Case Reports.

“…Twenty-six cases of ASDH showing rapid spontaneous resolution have been reported since 1985 (Table 1), [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] and several possible mechanisms for the spontaneous resolution have been proposed. Two mechanisms are dilution of the hematoma by CSF due to tearing of the arachnoid membrane followed by wash out, 1,4,5,8,11,12) and compression of the hematoma by acute brain swelling followed by redistribution.…”

Rapid Spontaneous Resolution of Signs of Intracranial Herniation Due to Subdural Hematoma. Case Report.

“…1,8,10,11,15) Therefore, the mechanism of the resolution is likely to be related to the diminution of ASDH. 1,3,6,[8][9][10][11]13,[15][16][17] However, the reason why such spontaneous resolution occurs in the cases of ASDH and no in those of CSDH remains unknown. 5,7,14) ASDH usually disappears relatively rapidly, but posttraumatic hygroma may develop during the course.…”

“…2) The signs of herniation in our patient observed on admission resolved within only 6 hours. Only eight of the many case reports on the disappearance and diminution of ASDH described the resolution of signs of herniation 1,8,10,11,15) ( Table 1). The ASDH in most previous cases disappeared completely within 24 hours after the onset.…”

“…Her coagulant factors such as prothrombin time, partial thromboplastin time, and platelet count were within the normal range. 15) There was no known history of head trauma. However, her family noticed that she had tended to fall to the right a few days previously.…”

“…1,8,10,11,15) Patients with signs of herniation should undergo immediate surgery to prevent uncal or central herniation. However, even successful surgical intervention does not prevent death or vegetative state in most patients with signs of herniation.…”