J Cerebrovasc Endovasc Neurosurg.  2012 Jun;14(2):104-107. 10.7461/jcen.2012.14.2.104.

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma

• Han SH
• Lee HK
• Moon JG
• Kim CH
• Cho TG

• KMID: 1808445
• DOI: http://doi.org/10.7461/jcen.2012.14.2.104

Abstract

Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performed due to the refusal of patient's family. Therefore, we decided to treat with conservative therapy. However, follow-up brain CT 16 hours after initial scan showed a remarkable reduction of previous sICH. The mechanism involving the spontaneous rapid decrease of the hematoma is presumed to occur through redistribution in brain atrophy, compression effect from the increased intracranial pressure and dilution through a wash out by the cerebrospinal fluid.

Keyword

Intracerebral hematoma; Spontaneous reduction; Redistribution

MeSH Terms

Aged
Atrophy
Brain
Disulfiram
Emergencies
Follow-Up Studies
Hematoma
Hematoma, Subdural, Acute
Humans
Intracranial Pressure
Disulfiram

Figure

• 

  Fig. 1 Initial brain computed tomography (CT) showed a 10.0 × 5.3 × 8.0 cm sized acute intracerebral hematoma on the right basal ganglia which extend into the frontal lobe as well as subarachnoid and intraventricular hemorrhages with a severe midline shift of 2.2 cm

• 

  Fig. 2 Follow-up brain CT after 16 hours demonstrated remarkable decrease in the volume of sICH to about 125 cc and showed the decrease of the mass effect and the increase of subarachnoid hemorrhages and intraventricular hemorrhages

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  Fig. 3 Postoperative CT revealed a remarkable decrease in the volume of the hematoma compared with that of hematoma in the initial CT imaging

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