gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Rapid resolution of large acute subdural hematoma: Report of four cases

Meeting Abstract

  • M. Oinuma - Department of Neurosurgery, Southern Tohoku Fukushima Hospital, Fukushima Japan
  • M. Sato - Department of Neurosurgery, Southern Tohoku Fukushima Hospital, Fukushima Japan
  • M. Nakano - Department of Neurosurgery, Southern Tohoku Fukushima Hospital, Fukushima Japan
  • J. Asari - Department of Neurosurgery, Southern Tohoku Fukushima Hospital, Fukushima Japan
  • K. Watanabe - Department of Neurosurgery, Southern Tohoku Fukushima Hospital, Fukushima Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 007

DOI: 10.3205/12dgnc395, URN: urn:nbn:de:0183-12dgnc3953

Published: June 4, 2012

© 2012 Oinuma et al.
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Outline

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Objective: Although rapid resolution (RR) of acute subdural hematoma (SDH) has rarely been observed, the mechanism is not well understood.

Methods: Here, we present 4 case reports of RR of a large acute SDH with midline shift.

Results: Case 1: A 92-year-old female fell and sustained head trauma. On admission she had a GCS score of 7 points. CT showed a large acute SDH and a thin low density band (TLDB), which implied the involvement of CSF existed in the SDE. A second CT disclosed a RR of SDE 8 h after admission. She was discharged with a moderate left hemiparesis. Case 2: A 88-year-old male suffered head trauma. On admission he had GCS score of 10 points. CT showed a large acute SDH. A TLDB existed in the SDE. A second CT showed a RR of SDE 3h after admission. His condition improved soon. However, he suffered acute renal failure and died 2 weeks later. Case 3: A 67-year-old male suffered head trauma. On admission he had GCS score of 7 points and anisocoria. CT showed a large acute SDH. A TLDB existed in the SDE. A second CT showed a RR of SDE 1h after admission. His condition improved soon. However, he suffered status epilepticus and died 3 days later. Case 4: A 72-year-old male suffered sudden consciousness disturbance. On admission he had GCS score of 5 points and anisocoria. CT showed a large acute SDH. A TLDB existed in the hematoma. A second CT showed a RR of SDE 12h after admission. His condition improved soon. However, he developed chronic SDH and underwent hematoma evacuation 2 weeks later and discharged with no deficits.

Conclusions: It was indicated that a mechanism of RR of acute SDH was attributable to CSF dilution and cerebral atrophy resulting from aging.