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[Rapid resolution of acute subdural hematoma; report of two cases]
T Joki1, T Hashimoto, K Akachi
1Department of Neurosurgery, Jikei University School of Medicine.
Abstract:
We reported two cases of rapid resolution of acute subdural hematoma. Case 1, a 21-year-old female, sustained head trauma and became unconscious for about 15 min. Probably she was suffering from posttraumatic amnesia for about 1 day. On admission J.C.S and G.C.S were 20 and 9 (2 + 2 + 5) points, respectively. Neurological examination showed no abnormalities. An initial computed tomography (CT) scan taken 2 hours after the injury showed a high dense subdural hematoma on the left cerebral hemisphere and hemispheric swelling. She was conservatively treated. A follow up CT scan taken 8 hours after the injury disclosed rapid disappearance of the hematoma and cerebral swelling. Case 2a 23-year-old male, sustained head trauma and became unconscious for about 30 min. On admission J.C.S and G.C.S were 1 and 14 (4 + 4 + 6) points, respectively, and slight right hemiparesis was noted. An initial CT scan taken 2 hours after the injury showed subdural hematoma of the left cerebral hemisphere and hemispheric swelling. He was conservatively treated. A follow up CT scan taken 24 hours after the injury revealed almost complete disappearance of the subdural hematoma and cerebral swelling. It was suggested that the rapid resolution of acute subdural hematoma was attributable to redistribution due to decrease of ICP, and washing out by cerebrospinal fluid.