J Korean Med Sci.  2000 Oct;15(5):560-568. 10.3346/jkms.2000.15.5.560.

The fate of traumatic subdural hygroma in serial computed tomographic scans

• Lee KS
• Bae WK
• Bae HG
• Yun IG

• KMID: 965880
• DOI: http://doi.org/10.3346/jkms.2000.15.5.560

Abstract

We reviewed serial computed tomographic (CT) scans of 58 patients with traumatic subdural hygroma (SDG) to investigate its natural history. All were re-evaluated with a special reference to the size and density of SDG. Thirty-four patients (58.6%) were managed conservatively and 24 patients (41.4%) underwent surgery. The lesion was described as remained, reduced, resolved, enlarged and changed. Means of interval from injury to diagnosis and any changes in CT were calculated. SDGs were resolved in 12 (20.7%), reduced in 15 (25.9%), remained in 10 (17.2%), enlarged in 2 (3.4%), and changed into chronic subdural hematoma (CSDH) in 19 patients (32.8%). SDG was diagnosed at 11.6 days after the injury. It was enlarged at 25.5 days, remained at 46.0 days, reduced at 59.3 days, resolved at 107.5 days, and changed into CSDH at 101.5 days in average. SDGs were developed as delayed lesions, and changed sequentially. They enlarged for a while, then reduced in size. The final path of a SDG was either resolution or CSDH formation. Nearly half of SDGs was resolved or reduced within three months, however, 61.3% of unresolved or unreduced SDG became iso- or hyperdense CSDH. These results suggest that the unresolved SDG is the precursor of CSDH.

Keyword

Lymphangioma, Crystic; Hematoma Subdural; Tomography, X-Ray Computed; Head Injuries

MeSH Terms

Adolescence
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Craniocerebral Trauma/complications
Disease Progression
Hematoma, Subdural, Chronic/radiography*
Hematoma, Subdural, Chronic/pathology*
Hematoma, Subdural, Chronic/etiology
Human
Infant
Longitudinal Studies
Lymphangioma/radiography
Lymphangioma/pathology
Lymphangioma/etiology
Middle Age
Subdural Effusion/radiography*
Subdural Effusion/pathology*
Subdural Effusion/etiology
Tomography, X-Ray Computed*