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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2016; 05(03): 207-212
DOI: 10.1055/s-0036-1581986
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Delayed Development of Traumatic Life-Threatening Acute Subdural Hematoma and Its Management: Challenge for Neurosurgeon — A Case Report and Review of Literature

Pratap Chandra Nath
1   Department of Neurosurgery, Shri Ramachandra Bhanj Medical College, Cuttack, Odisha, India
,
Sudhansu Sekhar Mishra
1   Department of Neurosurgery, Shri Ramachandra Bhanj Medical College, Cuttack, Odisha, India
,
Somnath Prasad Jena
1   Department of Neurosurgery, Shri Ramachandra Bhanj Medical College, Cuttack, Odisha, India
,
Soubhagya Ranjan Tripathy
1   Department of Neurosurgery, Shri Ramachandra Bhanj Medical College, Cuttack, Odisha, India
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Abstract

Delayed development of traumatic acute subdural hematoma in patients having a coagulation disorder with or without taking anticoagulants have been well reported in literature. But delayed development of acute subdural hematoma (ASDH) in patients with head injury without any coagulation disorder is rare as per our knowledge. In this case report, we are reporting a 28-year-old male patient, who developed delayed posttraumatic life-threatening ASDH after 48 hours of trauma. The patient had no coagulation disorder. He was not an alcoholic and all his examinations, including coagulation profile, liver function tests, and peripheral smear examination were within the normal limits. We want to highlight that mere absence of a lesion on computed tomography and negative clinical, with radiological finding, at an emergency department, does not always hold the eligibility to discharge a head injury patient. Observation for at least 24 hours with subsequent minimum one short interval follow-up is necessary for the safety of the patient.

Keywords

delayed - life-threatening ASDH - rete vasorum


Publication History

Received: 08 March 2015

Accepted: 18 December 2015

Publication Date:
08 June 2016 (online)

© 2016. Thieme. All rights reserved.

Thieme Medical Publishers

 

  • References

  • 1 Bollinger O. Uber traumatische Spat-Apoplexie: Ein Beitrag zur lehre von der Hirnerschutterung. In Internationale Beitrage Zur Wissenschlaftlichen Medizen. Festschrift, Rudolf Virchow (eds.). A. Hirschwald, Berlin: 1891: 457-470
    Google Scholar
  • 2 Diaz FG, Yock Jr DH, Larson D, Rockswold GL. Early diagnosis of delayed posttraumatic intracerebral hematomas. J Neurosurg 1979; 50 (02) 217-223
    Google Scholar
  • 3 Gudeman SK, Kishore PRS, Miller JD, Girevendulis AK, Lipper MH, Becker DP. The genesis and significance of delayed traumatic intracerebral hematoma. Neurosurgery 1979; 5 (03) 309-313
    Google Scholar
  • 4 Nelson AT, Kishore PR, Lee SH. Development of delayed epidural hematoma. AJNR Am J Neuroradiol 1982; 3 (05) 583-585
    Google Scholar
  • 5 Cassin BJ, Spitz WU. Concentration of alcohol in delayed subdural hematoma. J Forensic Sci 1983; 28 (04) 1013-1015
    Google Scholar
  • 6 Koumtchev Y, Petkov S, Gozmanov G. A case of delayed subdural hematoma. Folia Med (Plovdiv) 1994; 36 (02) 59-61
    Google Scholar
  • 7 Matsuda W, Sugimoto K, Sato N, Watanabe T, Fujimoto A, Matsumura A. Delayed onset of posttraumatic acute subdural hematoma after mild head injury with normal computed tomography: a case report and brief review. J Trauma 2008; 65 (02) 461-463
    Google Scholar
  • 8 Chen S, Xu C, Yuan L, Tian H, Cao H, Guo Y. Fatal deterioration of delayed acute subdural hematoma after mild traumatic brain injury: two cases with brief review. Chin J Traumatol 2014; 17 (02) 115-117
    Google Scholar
  • 9 Fukamachi A, Nagaseki Y, Kohno K, Wakao T. The incidence and developmental process of delayed traumatic intracerebral hematomas. Acta Neurochir (Wien). 1985; 74: 35-39
    Google Scholar
  • 10 Zervas NT, Liszczak TM, Mayberg MR, Black PM. Cerebrospinal fluid may nourish cerebral vessels through pathways in the adventitia that may be analogous to systemic vasa vasorum. J Neurosurg 1982; 56 (04) 475-481
    Google Scholar