scholarly journals Rapid spontaneous resolution of traumatic acute subdural hematoma

2019 ◽  
pp. 464-469
Author(s):  
Gautam Sachidanand ◽  
Shringi Prashant
Keyword(s):  
Subdural Hematoma ◽  
Prognostic Score ◽  
Head Injuries ◽  
Critical Role ◽  
Case Series ◽  
Neurological Status ◽  
Spontaneous Resolution ◽  
Acute Subdural Hematoma ◽  
High Morbidity ◽  
Rapid Reduction

Introduction: Acute subdural hematoma (ASDH) is the most common type of traumatic intra -cranial hematoma accounting for 24% cases of severe head injuries and caries highest mortality. The mortality rates are seen to be ranging from 40% to 90%, diagnosed on computed tomography (CT) as extra axial, hyperdense, crescent lesion between the Dura and brain parenchyma1. Acute SDH is an acute space occupying lesion to increase intracranial pressure (ICP), and is often complicated by co-existing intracranial lesions, including a variety of diffuse injuries, contusional hematomas, and edema. Acute subdural post-traumatic hematoma’s (SDH) continue to have a distressingly high morbidity and mortality.2 Clinical factors like presenting GCS, Pupils, time to operative interval, Hemodynamics and co-morbidities, plays a critical role in overall outcome from acute subdural hematoma.3Careful monitoring of the neurological status is mandatory even for selected acute SDH patients with intact consciousness and no brain shift because of the possibility of the unexpected worsening. Spontaneous resolution of an acute SDH has been reported in rare cases. We report a case series of spontaneous rapid reduction of acute SDH, also we discuss the prognosis of each patient according to a Clinicoradiological Prognostic Score developed by Gautam and Sharma3 as well as mechanisms related to the rapid resolution of acute SDH.

scholarly journals Rapid spontaneous resolution of the acute subdural hematoma: Case series and review of literature

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Lavlesh Rathore ◽  
Debabrata Sahana ◽  
Sanjeev Kumar ◽  
RajivK Sahu ◽  
AmitK Jain ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Case Series ◽  
Spontaneous Resolution ◽  
Acute Subdural Hematoma ◽  
Review Of Literature

Predictors of rapid spontaneous resolution of acute subdural hematoma

2014 ◽  
Vol 118 ◽  
pp. 94-97 ◽  
Author(s):  
Kenji Fujimoto ◽  
Tadahiro Otsuka ◽  
Kimio Yoshizato ◽  
Jun-ichi Kuratsu
Keyword(s):  
Subdural Hematoma ◽  
Spontaneous Resolution ◽  
Acute Subdural Hematoma

Acute subdural hematoma

1982 ◽  
Vol 57 (2) ◽  
pp. 254-257 ◽  
Author(s):  
Henry A. Shenkin
Keyword(s):  
Computerized Tomography ◽  
Subdural Hematoma ◽  
Neurological Status ◽  
Neurological Dysfunction ◽  
Acute Subdural Hematoma ◽  
Consecutive Series ◽  
Content Type ◽  
Subdural Hematomas ◽  
Fine Print

✓ In a consecutive series of 39 cases of acute subdural hematoma (SDH), encountered since computerized tomography diagnosis became available, 61.5% were found to be the result of bleeding from a small cortical artery, 25.6% were of venous origin, 7.7% resulted from cerebral contusions, and 5% were acute bleeds into chronic subdural hematomas. Craniotomy was performed promptly on admission, but there was no difference in survival (overall 51.3%) between patients with arterial and venous bleeds. The only apparent factor affecting survival in this series was the preoperative neurological status: 67% of patients who were decerebrate and had fixed pupils prior to operation died. Of patients with less severe neurological dysfunction, only 20% failed to survive.

scholarly journals Rapid Spontaneous Resolution of Acute Subdural Hematoma Occurs by Redistribution. Two Case Reports.

2001 ◽  
Vol 41 (3) ◽  
pp. 140-143 ◽  
Author(s):  
Noriyuki KATO ◽  
Takashi TSUNODA ◽  
Akira MATSUMURA ◽  
Kiyoyuki YANAKA ◽  
Tadao NOSE
Keyword(s):  
Subdural Hematoma ◽  
Case Reports ◽  
Spontaneous Resolution ◽  
Acute Subdural Hematoma

scholarly journals Spontaneous resolution of large non-traumatic bilateral acute-on-chronic subdural hematoma

2017 ◽  
Vol 31 (1) ◽  
pp. 8-16
Author(s):  
D. Adam ◽  
D. Iftimie ◽  
Gina Burduşa ◽  
Cristiana Moisescu
Keyword(s):  
Conservative Treatment ◽  
Subdural Hematoma ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Chronic Subdural Hematoma ◽  
The Elderly ◽  
Neurological Status ◽  
Spontaneous Resolution ◽  
Subdural Hematomas ◽  
Gcs Score

Abstract Background and importance: Chronic subdural hematomas are a frequently encountered neurosurgical pathology, especially in the elderly. They often require surgical evacuation, but recent studies have shown good results with conservative treatment in selected cases. Clinical presentation: We report the case of a 72-year old patient that developed large, non-traumatic, bilateral, acute-on-chronic subdural hematoma after repeated abdominal surgery for appendicular carcinoma. He presented an abdominal wound infection and good neurological status (GCS score of 14 points), factors that indicated the delay of surgical intervention. Subsequent clinical and radiological improvement forestalled the operation altogether and he presented complete spontaneous resolution of subdural hematomas at only 5 months after diagnosis. Conclusion: Although surgical treatment is performed in the majority of chronic subdural hematomas, in clinically and radiologically selected cases, the operation can be avoided. The hematoma can present resolution, either spontaneously or with the help of conservative treatment.

scholarly journals A clinicoradiological scoring for management of acute subdural hematoma: a prospective study

2018 ◽  
Vol 32 (2) ◽  
pp. 359-365
Author(s):  
Sachidanand Gautam ◽  
Anubhav Sharma ◽  
S.C. Dulara
Keyword(s):  
Prospective Study ◽  
Subdural Hematoma ◽  
Scoring System ◽  
Head Injuries ◽  
Postoperative Outcome ◽  
Clinical History ◽  
Acute Subdural Hematoma ◽  
Subdural Hemorrhage ◽  
Male Predominance ◽  
A Prospective Study

Abstract Background: Acute subdural hematoma is the most common type of traumatic intra cranial hematoma accounting for 24% cases of severe head injuries and caries highest mortality. The aim of this study is to analyze the prognostic factors and to propose Neuro-clinical and radiological prognostic scoring system on the clinical spectrum and to evaluate the postoperative outcome and validate the same. Methods: This is a prospective Study which included 100 patients admitted in Government Medical College, Kota, Rajasthan from 01st Jan 2016 to 30 June 2017 with head injury and were diagnosed to have Traumatic Subdural Hemorrhage. A detailed clinical history, Physical examination, Computerized Tomography scan was performed in all patients and were divided into 2 groups; that is conservative or surgical interventional as per Neuro-clinical and radiological prognostic scoring system. Results: The maximum patients suffering from Subdural Hematoma were in the age group of 11-60 years with male predominance 72%. The most common mode of injury was RTA with 68 % of incidence. 36 out of 100 cases presented to hospital with GCS <8 while 44 patients showed improvement of GCS after resuscitation. Out of 100 cases, surgical approach was considered in 34 patients while remaining patients were managed conservatively. Pupillary reaction, Hypotension, CT scan findings that is, thickness of hematoma >10mm and midline shift of >5mm, delay in interval between the surgery had greatly affected on outcome of patients. Conclusions: According to the results, use of Neuro-clinical and radiological prognostic scoring system is very useful in determining early intervention and also avoids unnecessary surgical intervention.

scholarly journals Clinical Predictors of outcome in Isolated Traumatic Acute Subdural Hematoma

2018 ◽  
Vol 15 (3) ◽  
pp. 8-13
Author(s):  
Maya Bhattachan ◽  
Ali Niyaf ◽  
Ram K. Shrestha ◽  
Amit Pradhananga ◽  
Gopal Sedain ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Adult Population ◽  
Radiological Finding ◽  
Acute Subdural Hematoma ◽  
Study Patient ◽  
High Morbidity ◽  
Midline Shift ◽  
Clinical Predictors ◽  
Hematoma Volume ◽  
Factors Affecting

Head injury is the major cause of death in young adult population worldwide with associated high morbidity. The objective of this study is to find out the outcome and factors affecting the outcome in isolated traumatic acute subdural hematoma. All patients with isolated acute subdural hematoma presenting within 24 hours of trauma and admitted over a period of 1 year were included in this study. Patient was classified according to Glasgow Coma Scale(GCS) after resuscitation in the emergency department. The outcome of the patient was recorded according to the Glasgow Outcome Scale at the time of discharge and at 3 months after the trauma in follow-up. Statistical analysis was performed to find the correlation between GCS, papillary changes and radiological finding in the form of midline shift and hematoma volume to dichotomized outcome. Out of 38 patients enrolled in the study, 33 patients had favorable outcome. Surgery was performed in 12 patients out of whom 4 patients had unfavorable outcome. GCS score, papillary changes, midline shift and hematoma volume were found to have significant association with the outcome in isolated traumatic acute subdural hematoma. Clinical parameters and radiological parameters can gauge the outcome in isolated traumatic brain injury.

Spontaneous resolution of traumatic acute subdural hematoma with good clinical outcome: A report of two cases

2014 ◽  
Vol 11 (2) ◽  
pp. 146-149
Author(s):  
Vinay Byrappa ◽  
Sonia Bansal ◽  
Sriganesh Kamath ◽  
Gopala Krishna N. Kadarapura
Keyword(s):  
Clinical Outcome ◽  
Subdural Hematoma ◽  
Spontaneous Resolution ◽  
Acute Subdural Hematoma ◽  
Good Clinical Outcome

scholarly journals Twist drill craniostomy for traumatic acute subdural hematoma in the elderly: case series and literature review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Pei-kun Huang ◽  
Yong-zhong Sun ◽  
Xue-ling Xie ◽  
De-zhi Kang ◽  
Shu-fa Zheng ◽  
...  
Keyword(s):  
Literature Review ◽  
Subdural Hematoma ◽  
Case Series ◽  
The Elderly ◽  
Acute Subdural Hematoma ◽  
Twist Drill

Frequency of and Risk Factors for Chronification in Traumatic Acute Subdural Hematoma following Conservative Therapy

2019 ◽  
Vol 80 (05) ◽  
pp. 359-364 ◽  
Author(s):  
Stefanie Kaestner ◽  
Marina van den Boom ◽  
Wolfgang Deinsberger
Keyword(s):  
Risk Factors ◽  
Subdural Hematoma ◽  
Head Injuries ◽  
Chronic Subdural Hematoma ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Coagulation System ◽  
Acute Subdural Hematoma ◽  
Neurosurgical Department ◽  
Anticoagulant Medication

Background In an aging society, traumatic head injuries, such as acute subdural hematomas (aSDHs), are increasingly common because the elderly are prone to falls and are often undergoing anticoagulation treatment. Especially in advanced age, cranial surgery such as craniotomies may put patients in further jeopardy. But if treatment is conservative, a chronic subdural hematoma (cSDH) may develop, requiring surgical evacuation. Existing studies have reported a correlation between several risk factors contributing to the frequency of chronification. To improve the prediction of the course of disease and to aid counseling patients and relatives, this study aimed to determine the frequency and the main risk factors influencing the process of chronification of an aSDH following conservative treatment. Methods We identified patients presenting between January 2012 and September 2017 at our neurosurgical department with an aSDH. All patients treated conservatively were selected retrospectively, and the following parameters were documented: age, sex, chronification status, Glasgow Coma Scale score on admission and discharge, hematoma thickness and density, the degree of midline shift (MLS), prior anticoagulants and administration of procoagulants, thrombosis management, other coagulopathies, initial length of hospital stay, interval between discharge and readmission, and interval between initial injury and date of surgery and last follow-up. The cohort was divided into patients with complete resolution of their aSDH, and patients who needed surgery due to chronification. Results A total of 75 conservatively treated patients with aSDH were included. A chronification was observed in 24 cases (32%). The process of chronification takes an average of 18 days (range: 10–98 days). The following factors were significantly associated with the process of chronification: age (p = 0.001), anticoagulant medication (acetylsalicylic acid [ASA], Coumadin, and novel anticoagulants [NOACs]) before injury (p = 0.026), administration of procoagulants (p = 0.001), presence of other coagulopathies such as thrombocytopenia (p = 0.002), low hematoma density at discharge (p = 0.001), hematoma thickness on admission and discharge (p = 0.001), and the degree of MLS (p = 0.044). Conclusion Chronification occurred in a third of all patients with conservatively treated aSDH, on average within 3 weeks. The probability of developing a cSDH is 0.96 times higher with every yearly increase in age, resulting in 56% chronification in patients ≥ 70 years. Hematoma thickness and impairment of the coagulation system such as anticoagulant medication (ASA, Coumadin, and NOACs) or thrombocytopenia are further risk factors for chronification.

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