Prompt Resorption of Traumatic Acute Subdural Hematoma –  a Case Report

Authors: J. Kašík 1;  J. Klener 1;  L. Tittelbach 1;  R. Tomáš 1;  J. Šroubek 1;  M. Mašek 2
Authors‘ workplace: Neurochirurgické oddělení, Nemocnice Na Homolce, Praha 1;  Radiodiagnostická klinika, Nemocnice Na Bulovce, Praha 2
Published in: Cesk Slov Neurol N 2016; 79/112(1): 86-89
Category: Case Report


Acute subdural hematoma (ASDH) is the most common type of traumatic intracranial hemorrhage associated with high morbidity and mortality. The majority of cases require acute surgery. Monitoring may rarely be sufficient in smaller asymptomatic ASDH. Their resorption is usually prolonged and often associated with formation of chronic subdural hematoma (CSDH). Prompt resorption of hematomas have been described in a few cases only but some authors argue that their incidence is underestimated. We present a case of traumatic ASDH in a young alcoholic patient, in whom a follow-up CT of the brain performed about 20 hours later revealed almost complete resorption of the hematoma.

Key words:
acute subdural hematoma – chronic subdural hematoma – prompt resorption

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


1. Matsuyama T, Shimomura T, Okumura Y, Sakaki T. Rapid resolution of symp­tomatic acute subdural hematoma: case report. Surg Neurol 1997; 48(2): 193– 196.

2. Zacko JC, Har­ris L, Bul­lock MR. Surgical management of traumatic brain injury. In: Win­n HR (ed.). Youmans Neurological Surgery. Vol. 4. Philadelphia: Saunders 2011: 3424– 3452.

3. Liu B, Zhuang Z, Luo J. Fluctuation of intra‑ parenchymal cerebral pres­sure may drive the rapid spontaneous resolution of acute subdural hematoma. Med Hypotheses 2013; 81(2): 159– 162. doi: 10.1016/ j.mehy.2013.05.019.

4. Towers WS, Kurtom KH. Spontaneous resolution of large acute subdural hematoma and the value of neurological exam in conservative management of high risk patients. Clin Neurol Neurosurg 2014; 118: 98– 100. doi: 10.1016/ j.clineuro.2013.12.014.

5. Bul­lock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newel­l DW et al. Surgical management of acute subdural hematomas. Neurosurgery 2006; 58 (Suppl 3): S16– S24.

6. Berker M, Gulsen S, Ozcan OE. Ultra rapid spontaneous resolution of acute posttraumatic subdural hematomas in patient with temporal linear fracture. Acta Neurochir (Wien) 2003; 145(8): 715– 717.

7. Coşar M, Eser O, Aslan A, Ela Y. Rapid resolution of acute subdural hematoma and ef­fects on the size of existent subdural hygroma: a case report. Turk Neurosurq 2007; 17(3): 224– 227.

8. Inamasu J, Nakamura Y, Saito R, Kuroshima Y, Mayanagi K, Ohba S et al. Rapid resolution of traumatic acute subdural hematoma by redistribution. Am J Emerg Med 2002; 20(4): 376– 377.

9. Lee CH, Kang DH, Hwang SH, Park IS, Jung JM. Spontaneous rapid reduction of a large acute subdural hematoma. J Korean Med Sci 2009; 24(6): 1224– 1226. doi: 10.3346/ jkms.2009.24.6.1224.

10. Mirzai H, Yaldiz C, Eminoglu M, Orguc S. Ultra fast resolution of acute post‑traumatic subdural hematoma. J Neurol Neurosurg Psychiatry 2005; 76(12): 1738.

11. Nagao T, Aoki N, Mizutani H, Kitamura K. Acute subdural hematoma with rapid resolution in infancy: case report. Neurosurgery 1986; 19(3): 465– 467.

12. Suzuki Y, Kawamata T, Matsumoto H, Kunii N, Matsumoto K. A resolv­ing sign of acute subdural hematoma: from report of two cases. No Shinkei Geka 1998; 26(11): 1025– 1029.

13. Seong S, Chang JY, Sang GL. Natural course of initial­ly non‑operated cases of acute subdural hematoma: the risk factors of hematoma progres­sion. J Korean Neurosurg Soc 2013; 54(3): 211– 219. doi: 10.3340/ jkns.2013.54.3.211.

14. Osborn AG. Dia­gnostic neuroradiology. St. Louis: Mosby 1994: 205– 207.

15. Kato N, Tsunoda T, Matsumura A, Yanaka K, Nose T. Rapid spontaneous resolution of acute subdural hematoma occurs by redistribution –  two case reports. Neurol Med Chir (Tokyo) 2001; 41(3): 140– 143.

16. Erol FS, Kaplan M, Topsakal C, Ozveren MF, Tiftikci MT. Coexistence of rapidly resolv­ing acute subdural hematoma and delayed traumatic intracerebral hemor­rhage. Pediatr Neurosurg 2004; 40(5): 238– 240.

17. Hadjigeorgiou G, Chamilos C, Petsanas A, Vranos G, Foteas P, Spiridakis F. Rapid spontaneous resolution of acute subdural hematoma in a patient with chronic alcoholism. Br J Neurosurg 2012; 26(3): 415– 416. doi: 10.3109/ 02688697.2011.631619.

18. Huang SH, Lee HM, Lin CK, Kwan AL, Howng SL, Loh JK. Rapid resolution of infantile acute subdural hematoma: a case report. Kaohsiung J Med Sci 2005; 21(6): 291– 294.

19. Watanabe A, Omata T, Kinouchi H. Rapid reduction of acute subdural hematoma and redistribution of hematoma: case report. Neurol Med Chir (Tokyo) 2010; 50(10): 924– 927.

20. Tsui EY, Fai Ma K, Cheung YK, Chan JH, Yuen MK. Rapid spontaneous resolution and redistribution of acute subdural hematoma in a patient with chronic alcoholism: a case report. Eur J Radiol 2000; 36(1): 53– 57.

21. Dong‑Won S, Chan‑ Young Ch, Chae‑ Heuck L. Spontaneously rapid resolution of acute subdural hemor­rhage with severe midline shift. J Korean Neurosurg Soc 2013; 54(5): 431– 433. doi: 10.3340/ jkns.2013.54.5.431.

22. Jae‑ Young P, Kyung‑ Sub M, Jung‑ Kil L, Kyung‑ Woon J. Rapid resolution of acute subdural hematoma in child with severe head injury: a case report. J Med Case Rep 2013; 7(3): 67. doi: 10.1186/ 1752‑ 1947‑ 7‑ 67.

23. Wen L, Liu WG, Ma L, Zhan RY, Li G, Yang XF. Spontaneous rapid resolution of acute subdural hematoma after head trauma: is it truly rare? Case report and relevant review of the literature. Ir J Med Sci 2009; 178(3): 367– 371. doi: 10.1007/ s11845‑ 008‑ 0168‑ 5.

24. Fujimoto K , Otsuka T , Yoshizato K , Kuratsu J. Predictors of rapid spontaneous resolution of acute subdural hematoma. Clin Neurol Neurosurg 2014; 118: 94– 97. doi: 10.1016/ j.clineuro.2013.11.030.

25. Kim BJ, Park KJ, Park DH. Risk factors of delayed surgical evacuation for initial­ly non‑operative acute subdural hematomas fol­low­ing mild head injury. Acta Neurochir (Wien) 2014; 156(8): 1605– 1613. doi: 10.1007/ s00701‑ 014‑ 2151‑ 4.

Paediatric neurology Neurosurgery Neurology

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