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Acute interhemispheric subdural hematomas. Report of nine cases
1Ondokuz Mayis University, School of Medicine, Department of Neurosurgery, Samsun, Turkey.
Insights
Acute interhemispheric subdural hematoma (ISH) can affect all age groups following trauma. ISH and acute subdural hematoma (SH) share similar mortality rates in patients with comparable neurological status.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Neurology
Background:
- Acute interhemispheric subdural hematoma (ISH) is a critical condition often resulting from trauma.
- Understanding the presentation, prognosis, and progression of ISH is crucial for effective patient management.
Observation:
- This study presents nine male patients with acute ISH, all with trauma as the etiology.
- Prognosis was poor for young adults and a child due to severe clinical presentation and high mortality.
- Asymptomatic patients were managed conservatively.
Findings:
- Acute ISH occurs across all age groups, from infants (shaken baby syndrome) to elderly patients on anticoagulants.
- Acute ISH does not appear to progress into chronic convexity subdural hematoma (SH); they may coexist simultaneously.
- Mortality rates for ISH and acute SH are comparable in patients with similar neurological status.
Implications:
- The findings challenge previous assumptions about ISH progression and mortality.
- This research highlights the diverse demographic affected by ISH and emphasizes the need for tailored treatment strategies.
- Further investigation into the specific mechanisms and outcomes of ISH in different age groups is warranted.
Abstract:
Nine male patients with acute interhemispheric subdural hematoma (ISH) are presented. The etiologic factor was trauma for all patients (traffic accident and falling down). The young adult cases and one child had bad prognosis due to severe clinical findings and high mortality. The asymptomatic patients were treated conservatively. In this report, we discussed etiologic factors, presentation of age groups, whether an ISH progresses to a chronic convexity subdural hematoma (SH), and real mortality rates for ISH with relevant literature knowledge. As a result, ISHs can present in all age groups including shaken babies, severely injured young adults as well as low velocity trauma striken elderly patients (especially those under anticoagulant medication). We believe that an acute ISH does not change to chronic convexity SH; in fact they present as simultaneous acute thin convexity SH and acute ISH. It is also concluded that in contrast to previous literature ISH and acute SH patients of similar neurological status have similar mortality rates.