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Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma

The majority of acute post-traumatic subdural hematomas (ASDH) require urgent surgical evacuation. Spontaneous resolution of ASDH has been reported in some cases. We report here on a case of a patient with a large amount of ASDH that was rapidly reduced. A 61-yr-old man was found unconscious followi...

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Autores principales: Lee, Chul-Hee, Kang, Dong Ho, Hwang, Soo Hyun, Park, In Sung, Jung, Jin-Myung, Han, Jong Woo
Formato: Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775881/
https://www.ncbi.nlm.nih.gov/pubmed/19949689
http://dx.doi.org/10.3346/jkms.2009.24.6.1224
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author Lee, Chul-Hee
Kang, Dong Ho
Hwang, Soo Hyun
Park, In Sung
Jung, Jin-Myung
Han, Jong Woo
author_facet Lee, Chul-Hee
Kang, Dong Ho
Hwang, Soo Hyun
Park, In Sung
Jung, Jin-Myung
Han, Jong Woo
author_sort Lee, Chul-Hee
collection PubMed
description The majority of acute post-traumatic subdural hematomas (ASDH) require urgent surgical evacuation. Spontaneous resolution of ASDH has been reported in some cases. We report here on a case of a patient with a large amount of ASDH that was rapidly reduced. A 61-yr-old man was found unconscious following a high speed motor vehicle accident. On initial examination, his Glasgow Coma Score scale was 4/15. His pupils were fully dilated and non-reactive to bright light. Brain computed tomography (CT) showed a massive right-sided ASDH. The decision was made to treat him conservatively because of his poor clinical condition. Another brain CT approximately 14 hr after the initial scan demonstrated a remarkable reduction of the previous ASDH and there was the new appearance of high density in the subdural space adjacent to the falx and the tentorium. Thirty days after his admission, brain CT revealed chronic SDH and the patient underwent surgery. The patient is currently able to obey simple commands. In conclusion, spontaneous rapid resolution/reduction of ASDH may occur in some patients. The mechanisms are most likely the result of dilution by cerebrospinal fluid and the redistribution of hematoma especially in patients with brain atrophy.
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spelling pubmed-27758812009-12-01 Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma Lee, Chul-Hee Kang, Dong Ho Hwang, Soo Hyun Park, In Sung Jung, Jin-Myung Han, Jong Woo J Korean Med Sci Case Report The majority of acute post-traumatic subdural hematomas (ASDH) require urgent surgical evacuation. Spontaneous resolution of ASDH has been reported in some cases. We report here on a case of a patient with a large amount of ASDH that was rapidly reduced. A 61-yr-old man was found unconscious following a high speed motor vehicle accident. On initial examination, his Glasgow Coma Score scale was 4/15. His pupils were fully dilated and non-reactive to bright light. Brain computed tomography (CT) showed a massive right-sided ASDH. The decision was made to treat him conservatively because of his poor clinical condition. Another brain CT approximately 14 hr after the initial scan demonstrated a remarkable reduction of the previous ASDH and there was the new appearance of high density in the subdural space adjacent to the falx and the tentorium. Thirty days after his admission, brain CT revealed chronic SDH and the patient underwent surgery. The patient is currently able to obey simple commands. In conclusion, spontaneous rapid resolution/reduction of ASDH may occur in some patients. The mechanisms are most likely the result of dilution by cerebrospinal fluid and the redistribution of hematoma especially in patients with brain atrophy. The Korean Academy of Medical Sciences 2009-12 2009-11-09 /pmc/articles/PMC2775881/ /pubmed/19949689 http://dx.doi.org/10.3346/jkms.2009.24.6.1224 Text en Copyright © 2009 The Korean Academy of Medical Sciences http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lee, Chul-Hee
Kang, Dong Ho
Hwang, Soo Hyun
Park, In Sung
Jung, Jin-Myung
Han, Jong Woo
Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma
title Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma
title_full Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma
title_fullStr Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma
title_full_unstemmed Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma
title_short Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma
title_sort spontaneous rapid reduction of a large acute subdural hematoma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775881/
https://www.ncbi.nlm.nih.gov/pubmed/19949689
http://dx.doi.org/10.3346/jkms.2009.24.6.1224
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