J Korean Neurosurg Soc.  2013 Nov;54(5):431-433. 10.3340/jkns.2013.54.5.431.

Spontaneously Rapid Resolution of Acute Subdural Hemorrhage with Severe Midline Shift

• Shin DW
• Choi CY
• Lee CH

• KMID: 2138362
• DOI: http://doi.org/10.3340/jkns.2013.54.5.431

Abstract

Acute subdural hematoma is usually a neurological emergency that requires hematoma evacuation or close observation. However, spontaneous resolutions of an acute subdural hematoma without surgical interventions have been reported rarely. We report on a case who showed rapid resolution of an acute subdural hematoma with neurological improvement and review the relevant literatures.

Keyword

Rapid; Resolution; Subdural hemorrhage

MeSH Terms

Emergencies
Hematoma
Hematoma, Subdural*
Hematoma, Subdural, Acute

Figure

• 

  Fig. 1 Brain CT reveals an acute subdural hematoma of 10 mm thickness with midline shift of 15 mm in the right frontotemporoparietal region. A band of low density in the subdural hematoma is seen.

• 

  Fig. 2 Follow-up brain CT shows a decrease of acute subdural hematoma (8 mm thickness) and improvement of midline shift (10 mm).

• 

  Fig. 3 Brain CT shows a remarkable resolution of acute subdural hematoma and recovery of midline shift (A). Subdural hematomas in around falx, tentorium, posterior fossa, upper cervical spinal canal are not found on the coronal (B) and sagittal brain CT (C).

Reference

1. Erol FS, Kaplan M, Topsakal C, Ozveren MF, Tiftikci MT. Coexistence of rapidly resolving acute subdural hematoma and delayed traumatic intracerebral hemorrhage. Pediatr Neurosurg. 2004; 40:238–240. PMID: 15687739.

2. Hadjigeorgiou G, Chamilos C, Petsanas A, Vranos G, Foteas P, Spiridakis F. Rapid spontaneous resolution of acute subdural haematoma in a patient with chronic alcoholism. Br J Neurosurg. 2012; 26:415–416. PMID: 22111954.

3. Huang SH, Lee HM, Lin CK, Kwan AL, Howng SL, Loh JK. Rapid resolution of infantile acute subdural hematoma : a case report. Kaohsiung J Med Sci. 2005; 21:291–294. PMID: 16035574.

4. Kato N, Tsunoda T, Matsumura A, Yanaka K, Nose T. Rapid spontaneous resolution of acute subdural hematoma occurs by redistribution--two case reports. Neurol Med Chir (Tokyo). 2001; 41:140–143. PMID: 11372558.

5. Tsui EY, Fai Ma K, Cheung YK, Chan JH, Yuen MK. Rapid spontaneous resolution and redistribution of acute subdural hematoma in a patient with chronic alcoholism : a case report. Eur J Radiol. 2000; 36:53–57. PMID: 10996759.

6. Watanabe A, Omata T, Kinouchi H. Rapid reduction of acute subdural hematoma and redistribution of hematoma : case report. Neurol Med Chir (Tokyo). 2010; 50:924–927. PMID: 21030807.

7. Wen L, Liu WG, Ma L, Zhan RY, Li G, Yang XF. Spontaneous rapid resolution of acute subdural hematoma after head trauma : is it truly rare? Case report and relevant review of the literature. Ir J Med Sci. 2009; 178:367–371. PMID: 18807104.