Shedding new light on rapidly resolving traumatic acute subdural hematomas

Brooke, Magdalene A.; Patel, Atul; Castro-Moure, Federico; Victorino, Gregory P.

doi:10.1016/j.jss.2017.05.106

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…According to all above literatures, predictable factors for rapid resolution were low-density band, coagulopathy, premorbid antiplatelet agent ingestion and presence of additional intracranial hemorrhage. And Brooke et al 3) reported their 29 cases and insisted 2 other predictable factors which were previously unrecognized; lower rates of comorbidities and prehospital anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

“…So called “low-density band” between ASDH and skull seen in CT scan suggests such CSF collection. 2 3 4 5 6 7 8 9 10 11 12 13 16 17 19 20) 2) Redistribution of hematoma to another space; contralateral intracranial space, intradiploic space and/or subgaleal space through the skull fracture, spinal subdural space, by raised pressure caused by brain swelling, other intracranial hemorrhages, and/or subdural hematoma itself. 1 3 4 5 6 7 8 9 10 11 12 13 14 16 17 19 20) It has been claimed also that brain atrophy leads to widening of subarachnoid space, which facilitates the removal of ASDH by aiding the redistribution of the hematoma.…”

Section: Discussionmentioning

confidence: 99%

“… 2 3 4 5 6 7 8 9 10 11 12 13 16 17 19 20) 2) Redistribution of hematoma to another space; contralateral intracranial space, intradiploic space and/or subgaleal space through the skull fracture, spinal subdural space, by raised pressure caused by brain swelling, other intracranial hemorrhages, and/or subdural hematoma itself. 1 3 4 5 6 7 8 9 10 11 12 13 14 16 17 19 20) It has been claimed also that brain atrophy leads to widening of subarachnoid space, which facilitates the removal of ASDH by aiding the redistribution of the hematoma. 1 5 8 12 13 19) Lee et al 12) suggest that the expanded subarachnoid space due to brain atrophy can be a favorable factor which could affect the dilution and redistribution of the hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, coagulopathy or premorbid ingestion of antiplatelet agent or anticoagulant is another ancillary factor contributes to rapid resolution. 3 4 7 13) …”

Section: Discussionmentioning

confidence: 99%

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Rapid Spontaneous Resolution of Large Acute Subdural Hematoma

Kwon

Hwang

Shin

2021

Korean J Neurotrauma

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Usually, acute subdural hematomas (ASDHs) result from head trauma and require urgent surgical treatment. However, there have been many reports of rapid spontaneous resolution of ASDHs since 1986. Recently, we experienced a case of a massive ASDH that resolved spontaneously within 1.5 days. A 76-year-old man was admitted to a local hospital after a head injury. According to his clinical records, his initial neurologic status was good (Glasgow Coma Scale score of 14). However, his head computer tomography (CT) scan demonstrated a massive ASDH to the right, with a significant midline shift. Based on his neurological status and general condition, surgery was not considered, and the patient was closely monitored in the intensive care unit. The next day, the patient was transferred to our hospital as requested by his family, after which his neurological state stabilized, and the customary follow-up brain CT was performed. It was about 32 hours after the patient's head injury, and it revealed an unexpected finding, near-total resolution of the ASDH. Herein, we review previously reported similar cases and relevant mechanisms of rapid resolution of the ASDH. We believe that neurosurgeons should comprehensively assess the patient's condition and CT findings and provide appropriate treatment, especially when surgical intervention is unnecessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In addition, coagulopathy or premorbid ingestion of antiplatelet agent or anticoagulant is another ancillary factor contributes to rapid resolution. 3 4 7 13) …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Rapid Spontaneous Resolution of Large Acute Subdural Hematoma

Kwon

Hwang

Shin

2021

Korean J Neurotrauma

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Mechanism for the Rapid Spontaneous Resolution of an Acute Subdural Hematoma and Transformation into a Subdural Hygroma

et al. 2018

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Swift Spontaneous Regression of a Pediatric Traumatic Acute Subdural Hematoma

et al. 2019

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We report the case of a 4-year-old girl with acute subdural hematoma who presented to the emergency department after an unwitnessed fall of the balcony. The hematoma was hyperdense along the left convexity of 9 mm thickness with a consequent mass effect with obliteration of the adjacent sulci, left lateral ventricle compression and a midline shift of 7 mm. During her stay in the emergency department while waiting for transfer to the children intensive care unit elsewhere she slightly deteriorated neurologically. Repeat CT scan of the brain 4 h after initial presentation remarkably showed that the subdural hematoma had now largely disappeared, with a decrease in volume and density. Consequently, the mass effect diminished with a near normalization of the midline shift.

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Shedding new light on rapidly resolving traumatic acute subdural hematomas

Cited by 5 publications

References 13 publications

Rapid Spontaneous Resolution of Large Acute Subdural Hematoma

Rapid Spontaneous Resolution of Large Acute Subdural Hematoma

Mechanism for the Rapid Spontaneous Resolution of an Acute Subdural Hematoma and Transformation into a Subdural Hygroma

Swift Spontaneous Regression of a Pediatric Traumatic Acute Subdural Hematoma

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