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Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature

BACKGROUND: Traumatic acute subdural hematoma (ASDH) is an oft encountered entity in neurosurgery. While resolution of such thick SDHs usually takes time, certain cases of rapid spontaneous resolution have also been reported. This article attempts to review the pathophysiology, clinical and radiolog...

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Autores principales: Rathore, Lavlesh, Sahana, Debabrata, Kumar, Sanjeev, Sahu, Rajiv K., Jain, Amit K., Tawari, Manish, Borde, Pravin R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202355/
https://www.ncbi.nlm.nih.gov/pubmed/34211864
http://dx.doi.org/10.4103/ajns.AJNS_380_20
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author Rathore, Lavlesh
Sahana, Debabrata
Kumar, Sanjeev
Sahu, Rajiv K.
Jain, Amit K.
Tawari, Manish
Borde, Pravin R.
author_facet Rathore, Lavlesh
Sahana, Debabrata
Kumar, Sanjeev
Sahu, Rajiv K.
Jain, Amit K.
Tawari, Manish
Borde, Pravin R.
author_sort Rathore, Lavlesh
collection PubMed
description BACKGROUND: Traumatic acute subdural hematoma (ASDH) is an oft encountered entity in neurosurgery. While resolution of such thick SDHs usually takes time, certain cases of rapid spontaneous resolution have also been reported. This article attempts to review the pathophysiology, clinical and radiological features of such cases, as well as provide an insight into decision making for their management. METHODS: Electronic literature search was done to look for similar cases of spontaneous rapid resolution of ASDH. Five of authors cases have been described. Their clinical and radiological features along with those of cases from literature search were tabulated and analyzed. RESULTS: A total of 44 relevant cases were included for analyses. Of these, 39 cases were from 33 articles found in existing literature and 5 cases were from author's collection. The M:F ratio was 25:19 with a mean age was 41.84(SD-4.094) years. Twenty -six patients showed “Rapid” neurological improvement (</= 24 hours) while “gradual” neurological improvement (>24 hours) occurred in 10 patients. The mean hematoma resolution time on CT scan was 13.78 hours (SD 16.46) ranging from 1- 72 hours. Twenty-nine patients showed redistribution of hematoma, most commonly to tentorium and falx cerebelli. CT scan findings were classified into 5 types as per the nature of hypodensity around hematoma. The geometric mean time to resolution of hematoma was least for type 2 (7.27 hours) and type 1(7.52 hours) patients. CONCLUSION: Selected patients of ASDH with rapid neurological improvement and specific CT findings may show spontaneous resolution of ASDH. Multicentric studies with larger study population may provide better insight into the nature and outcomes of such entities.
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spelling pubmed-82023552021-06-30 Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature Rathore, Lavlesh Sahana, Debabrata Kumar, Sanjeev Sahu, Rajiv K. Jain, Amit K. Tawari, Manish Borde, Pravin R. Asian J Neurosurg Review Article BACKGROUND: Traumatic acute subdural hematoma (ASDH) is an oft encountered entity in neurosurgery. While resolution of such thick SDHs usually takes time, certain cases of rapid spontaneous resolution have also been reported. This article attempts to review the pathophysiology, clinical and radiological features of such cases, as well as provide an insight into decision making for their management. METHODS: Electronic literature search was done to look for similar cases of spontaneous rapid resolution of ASDH. Five of authors cases have been described. Their clinical and radiological features along with those of cases from literature search were tabulated and analyzed. RESULTS: A total of 44 relevant cases were included for analyses. Of these, 39 cases were from 33 articles found in existing literature and 5 cases were from author's collection. The M:F ratio was 25:19 with a mean age was 41.84(SD-4.094) years. Twenty -six patients showed “Rapid” neurological improvement (</= 24 hours) while “gradual” neurological improvement (>24 hours) occurred in 10 patients. The mean hematoma resolution time on CT scan was 13.78 hours (SD 16.46) ranging from 1- 72 hours. Twenty-nine patients showed redistribution of hematoma, most commonly to tentorium and falx cerebelli. CT scan findings were classified into 5 types as per the nature of hypodensity around hematoma. The geometric mean time to resolution of hematoma was least for type 2 (7.27 hours) and type 1(7.52 hours) patients. CONCLUSION: Selected patients of ASDH with rapid neurological improvement and specific CT findings may show spontaneous resolution of ASDH. Multicentric studies with larger study population may provide better insight into the nature and outcomes of such entities. Wolters Kluwer - Medknow 2021-02-23 /pmc/articles/PMC8202355/ /pubmed/34211864 http://dx.doi.org/10.4103/ajns.AJNS_380_20 Text en Copyright: © 2021 Asian Journal of Neurosurgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Rathore, Lavlesh
Sahana, Debabrata
Kumar, Sanjeev
Sahu, Rajiv K.
Jain, Amit K.
Tawari, Manish
Borde, Pravin R.
Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature
title Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature
title_full Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature
title_fullStr Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature
title_full_unstemmed Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature
title_short Rapid Spontaneous Resolution of the Acute Subdural Hematoma: Case Series and Review of Literature
title_sort rapid spontaneous resolution of the acute subdural hematoma: case series and review of literature
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202355/
https://www.ncbi.nlm.nih.gov/pubmed/34211864
http://dx.doi.org/10.4103/ajns.AJNS_380_20
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