Korean J Neurotrauma.  2014 Oct;10(2):134-136. 10.13004/kjnt.2014.10.2.134.

Rapid Spontaneous Resolution of Acute Subdural Hematoma in a Patient with Liver Cirrhosis

• Bae HJ
• Lee SB
• Yoo DS
• Huh PW
• Lee TG
• Cho KS

• KMID: 2256249
• DOI: http://doi.org/10.13004/kjnt.2014.10.2.134

Abstract

Acute subdural hematoma (ASDH) constitutes one of the most critical emergencies in neurosurgery and rapid spontaneous resolution of ASDH is an infrequent phenomenon. Several mechanisms have been attributed to explain this phenomenon including redistribution of subdural blood, dilution by cerebral spinal fluid and brain atrophy. Rapid resolution of ASDH related to coagulopathy is a rare phenomenon; to our knowledge, only one case has been reported. We report on a patient who showed rapid resolution of ASDH with coagulopathy and also discuss such a rare case with speculation of the coagulopathy as a factor to promote this phenomenon.

Keyword

Hematoma subdural acute; Remission spontaneous; Blood coagulation disorder

MeSH Terms

Atrophy
Blood Coagulation Disorders
Brain
Emergencies
Hematoma, Subdural, Acute*
Humans
Liver Cirrhosis*
Neurosurgery

Figure

• 

  FIGURE 1 Initial computed tomography scan demonstrating a 23 mm thickness of acute subdural hematoma with midline shift of 15 mm in the left frontotemporoparietal region with herniation sign, compression of the brain stem. A band of low density between the subdural hematoma and inner table of the skull is seen.

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  FIGURE 2 A: Computed tomo-graphy (CT) scans 1 day after the 1st brain CT scan shows a decrea-se of acute subdural hematoma and improvement of midline shift. B: The other image showing pro-minent redistribution of the hematoma into the tentorial spaces.

• 

  FIGURE 3 Computed tomography scan 3 day after accident shows resolution of acute subdural hematoma and a minimal amount of chronic subdural hematoma in both sided.

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