Spontaneous and rapid resolution of post-traumatic acute subdural hematoma
Journal Title: Ege Tıp Dergisi - Year 2016, Vol 55, Issue 4
Abstract
A-63-year old woman was brought to our clinic with signs of intracranial herniation due to acute subdural hematoma (ASDH) after being involved in a traffic accident. On admission, she had hemiparesis and anisocoria and she was comatose with a Glasgow Coma Scale (GCS) score of 8. Brain computed tomography (CT) showed ASDH including low density areas in left temporoparietal region and evident midline shift. The patient was given mannitol as conservative treatment in the emergency room. Approximately one and a quarter hours later, her neurological level spontaneously improved; and her GCS score rose to 13. One and a half hours later, Control CT showed significant reduction in ASDH and midline shift. On the second day she was totally alert with a GCS score of 15. The second control CT taken approximately fifteen hours after her admission revealed no pathology. She was discharged with no neurological deficit. This case illustrates rapid and spontaneous resolution of ASDH. In the patient's initial CT, low density areas indicating the co-mingling of hematoma with cerebrospinal fluid (CSF) were observed. Therefore, we consider the dilution and washing out of hematoma with CSF as the main cause of the spontaneous and rapid resolution of ASDH.
Authors and Affiliations
Özgür Demir, Faruk Tonga
Keywords
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- EP ID EP341956
- DOI 10.19161/etd.344230
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