Background: Rapid spontaneous resolution of posttraumatic intracranial ASDH has been reported in the literature since 1986. We report a case to demonstrate that redistribution of hematoma to the spinal subdural space is a mechanism for the rapid spontaneous resolution of posttraumatic intracranial ASDH.
Case Description: A 73-year-old woman with a slipped-and-fell injury had a worst GCS score of 8/15. Computerized tomography of the brain demonstrated a large intracranial ASDH with mass effect. Conservative management was decided because of her poor premorbid general condition. Rapid clinical improvement was observed within 5 hours after the CT. Progress CT of the brain at 45 hours postinjury showed that the size of the intracranial ASDH was markedly diminished. The CT findings apparently demonstrated a caudal distribution of the intracranial ASDH over the tentorium and then into the posterior fossa. To investigate this further, an MRI of the spine was performed, which showed that there was spinal SDH in the cervical and thoracic spine.
Conclusion: This is the first report demonstrating that redistribution of posttraumatic intracranial ASDH to the spinal subdural space is one of the mechanisms behind the rapid spontaneous resolution of posttraumatic intracranial ASDH in the acute phase.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.surneu.2007.06.079 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Unravelling Secondary Brain Injury: Insights from a Human-Sized Porcine Model of Acute Subdural Haematoma.
Cells
December 2024
Institute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, Germany.
Article Synopsis
- Traumatic brain injury (TBI) is a leading cause of death, complicating the development of effective therapies due to the unique nature of each injury.
- Clinical questions regarding the benefits of measuring intracranial pressure, cerebral perfusion pressure, and surgical interventions remain largely unanswered.
- This study focused on acute subdural hematoma in a porcine model to better understand secondary brain injury and the effects of different injury patterns on outcomes, highlighting the need for comprehensive models to improve TBI treatment translation.
Pure Acute Subdural Hematoma of Cortical Non-mycotic Microaneurysmatic Etiology: A Report of Two Cases and a Literature Review.
Cureus
November 2024
Neurological Surgery, Hospital Central do Funchal, Funchal, PRT.
Pure acute subdural hematoma (ASDH) is an uncommon clinical presentation of ruptured intracranial aneurysms, and only rarely, the culprit is a cortical microaneurysm.Mortality can be high; thus, appropriate diagnosis and treatment are crucial. Due to its extreme rarity, there are no available guidelines.
View Article and Find Full Text PDFEffectiveness of Craniectomy Versus Craniotomy in the Management of Acute Subdural Hematoma Patients: A Systematic Review.
Cureus
December 2024
Pharmacology and Therapeutics, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Traumatic brain injuries (TBIs) represent a spectrum of neurological conditions resulting from external forces impacting the head, leading to temporary or permanent impairments in cognitive, emotional, or physical functioning. Acute subdural hematomas (ASDH) are a significant subset of TBIs characterized by the rupture of blood vessels within the subdural space between the brain and the dura mater. Management of ASDH typically involves two primary surgical procedures: craniectomy and craniotomy.
View Article and Find Full Text PDFAcute subdural hematoma from ruptured middle cerebral artery aneurysm: A rare and critical analysis of 25 cases.
Neurocirugia (Astur : Engl Ed)
November 2024
Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Seville, Spain.
Article Synopsis
- An acute subdural hematoma (aSDH) can arise from a ruptured MCA aneurysm, with a complex pathophysiology and uncertain prognosis, but early diagnosis and treatment may improve outcomes.
- Analysis of 25 cases revealed that most patients were around 51 years old, with significant loss of consciousness and neurological deficits, indicating severe cases requiring aggressive treatment.
- The study suggests that identifying anterior MCA aneurysm characteristics in patients with large aSDH, particularly without trauma history, is crucial for timely intervention and potentially better recovery outcomes.
Optimizing shunt integrity during acute subdural hematoma evacuation.
Surg Neurol Int
September 2024
Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan.
Article Synopsis
- Mild head trauma in patients with cerebrospinal fluid (CSF) shunts can lead to serious subdural hematoma (SDH), complicating treatment options for acute SDH (ASDH) in those with normal pressure hydrocephalus.
- A study analyzed five patients who underwent hematoma evacuation after adjusting their shunt valve pressure to the highest setting, focusing on clinical outcomes and treatment responses.
- Results showed that most patients were elderly, had neurological impairments, and experienced falls, with varying outcomes at discharge, indicating that proper management of shunt valve pressure may help prevent bleeding recurrence.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!