A case of intracranial migration and rapid spontaneous resolution of traumatic acute subdural hematoma

Melih Yuksel,Mehmet Goktekin,Mahmut Tas,Abdullah Mesut,Caner Saglam

doi:10.17546/msd.35348

Abstract

Traumatic acute subdural hematoma (ASDH) is one of the most destructive forms of traumatic brain injury (TBI), involving estimated mortality rates of 40-60% . Traumatic ASDH is a frequently seen life-threatening condition requiring emergency intervention. Spontaneous resolution and migration of ASDH are both rare entities, the causes of which are still not fully understood. The few existing cases in the literature of both rapid spontaneous resolution of SDH and of subdural migration are generally in the form of case reports. Publications concerning migration of SDH mainly involve migration to the lumbar region. We encountered no previous reports of intracranial migration of ASDH accompanied by rapid spontaneous resolution.  This report describes a case of intracranial migration and spontaneous resolution within 24 h in a 61-year-old male patient with traumatic Traumatic acute subdural hematoma (ASDH), together with a discussion of the relevant mechanisms.&nbsp

Highlights

CaseTraumatic acute subdural hematoma (ASDH) is one of the most destructive forms of traumatic brain injury (TBI), involving estimated mortality rates of 40-60% [1]
Monitoring and treatment of ASDH is based on serial computerized tomography (CT) of the brain, depending on the patient’s neurological status and thickness of hematoma
Surgical intervention is recommended in subdural hematomas (SDHs) greater than 10 mm, while surgery is not effective in hematomas smaller than 3 mm

Summary

Introduction

Traumatic acute subdural hematoma (ASDH) is one of the most destructive forms of traumatic brain injury (TBI), involving estimated mortality rates of 40-60% [1]. Monitoring and treatment of ASDH is based on serial computerized tomography (CT) of the brain, depending on the patient’s neurological status and thickness of hematoma. Surgical intervention is recommended in subdural hematomas (SDHs) greater than 10 mm, while surgery is not effective in hematomas smaller than 3 mm. Debate still continues regarding whether surgical intervention or a conservative approach is preferable in patients with a thickness of 5-10 mm and a Glasgow Coma Scale (GCS) score of 9-11 [3]. The time to resolution of ASDH in the literature varies between the first few hours after trauma to a few days [3,6]

Objectives

Conclusion