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Rapid Spontaneous Resolution of Large Acute Subdural Hematoma
Hee Chang Kwon1, Yong Soon Hwang1, Hyung Shik Shin1
1Department of Neurosurgery, Sanggye Paik Hospital, Inje University, Seoul, Korea.
Korean Journal of Neurotrauma
|November 11, 2021
Summary
Acute subdural hematomas (ASDHs) can resolve spontaneously, even massive ones. This case study highlights a massive ASDH that resolved in 1.5 days, challenging typical treatment approaches.
Area of Science:
- Neurosurgery
- Radiology
- Emergency Medicine
Background:
- Acute subdural hematomas (ASDHs) are typically associated with head trauma and necessitate immediate surgical intervention.
- While surgical treatment is standard, spontaneous resolution of ASDHs has been documented since 1986.
Observation:
- A case of a massive right-sided ASDH with significant midline shift in a 76-year-old male with a Glasgow Coma Scale score of 14 was observed.
- Despite the initial CT findings, surgical intervention was deferred due to the patient's stable neurological status and general condition.
Findings:
- A follow-up CT scan approximately 32 hours after the head injury revealed a near-total spontaneous resolution of the massive ASDH.
- This finding is consistent with previously reported cases of rapid ASDH resolution.
Implications:
- Neurosurgeons must conduct thorough assessments of patient condition and CT findings to determine appropriate management.
- The possibility of spontaneous resolution should be considered, potentially avoiding unnecessary surgical interventions in select ASDH cases.
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