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Differences in Presentation, Radiological Features, and Outcomes in Traumatic Versus Spontaneous Acute Subdural
Djino Khaki1, Johan Ljungqvist2, Astrid Kirknes3
1Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
World Neurosurgery
|April 29, 2022
Summary
Spontaneous acute subdural hematoma (sASDH) patients had better outcomes than traumatic cases. Further research is needed to identify the causes of sASDH.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Spontaneous acute subdural hematoma (sASDH) is a rare condition often documented through case reports.
- Limited comparative data exists for sASDH versus traumatic ASDH (tASDH).
Purpose of the Study:
- To compare presentation, radiological findings, and outcomes of sASDH versus tASDH in a population-based setting.
Main Methods:
- Retrospective analysis of 266 adult patients who underwent surgery for ASDH between 2010 and 2020.
- Cohort divided into sASDH (n=24) and tASDH (n=242) groups for comparative analysis.
Main Results:
- sASDH accounted for 9% of surgically evacuated ASDH cases.
- sASDH patients were older (mean 66.2 years) and presented with sudden headache.
- sASDH group showed higher Glasgow Coma Scale scores (10 vs. 8) and more favorable outcomes (72.7% vs. 41.5% GOS 4-5).
Conclusions:
- sASDH outcomes are significantly more favorable than tASDH.
- Arterial bleeding was observed in half of sASDH patients, often without clear preoperative radiological findings.
- Further research is required to establish optimal diagnostic methods for sASDH etiology.
