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

Abstract

Post-traumatic acute subdural hematoma (ASDH) requires immediate surgical evacuation in most cases. We present two cases of ASDH which resolved spontaneously. The first patient had 9 mm thick ASDH in left fronto-temporo-parietal region with initial GCS of E₁V₁M₃ which improved to E₂V_tM₄ within 7 h. Repeat CT of the brain showed a decrease in the size of ASDH. Hence, patient was conservatively managed with anti-edema measures and elective ventilation. The patient improved and ASDH also resolved completely. The second patient also had 8 mm thick ASDH in the right fronto-temporo-parietal region with GCS of E₁V₂M₅ which 5 h later improved to E₃V₄M₅. With conservative measures, there was clinical and radiological improvement. Based on previous reports, certain characteristic features have been shown to favor spontaneous resolution of ASDH; absence of underlying contusion and the presence of a low-density band between the skull and the hematoma on imaging were features common to our patients also.

Keywords

Acute subdural hematoma - Spontaneous resolution - Non-surgical management of acute SDH

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