[Acute spontaneous subdural hematoma--a case report (author's transl)]

Area of Science:

• Neurosurgery
• Neurology

Background:

• Acute spontaneous subdural hematoma (ASDH) is a rare and potentially life-threatening neurological emergency.
• This condition often presents with non-specific symptoms, making diagnosis challenging.

Observation:

• A 48-year-old male presented with sudden severe headache, progressing to unconsciousness and left hemiparesis.
• CT scan revealed a left temporal extra-axial high-density mass with significant midline shift.
• Initial coagulation studies were normal, and no external head trauma was evident.

Findings:

• Emergent left craniotomy successfully evacuated a subdural clot without an associated membrane.
• Two spurting cortical arteries with pin-hole defects were identified and coagulated during surgery.
• Postoperative angiography confirmed the absence of vascular malformations.

Implications:

• This case underscores the possibility of ASDH without apparent cause or identifiable vascular anomalies.
• Early surgical intervention is crucial for favorable outcomes in acute spontaneous subdural hematoma.
• Further review of literature cases provides insights into the characteristic features of ASDH.