Spontaneous Closure Of A Traumatic Middle Meningeal Arteriovenous Fistula
Neuroradiology 25(2): 1983; 105-109
View Original Source →Abstract
Our recent experience with four cases of acute extradural hematoma found in neurologically intact or mildly symptomatic patients is reported. These patients did not require operation; complete resolution of the hematoma was demonstrated within 1 month in three cases and within 4 months in the last case. Although far from being codified, nonsurgical treatment of extradural hematomas in some selected patients seems to be feasible. The computed tomographic findings (size and location of the hematoma, midline shift) in these cases are discussed.
Case Details
Personal Characteristics
75-year-old woman
Clinical Characteristics
Fell and struck her head after a syncopal attack, nausea, vomiting, severe left temporalgia, alert, blood pressure was 104/62 mmhg, pulse rate 86/minute, respiration rate 24/minute, contused wound in the right temporal region, pupils were equal in size and reactive to light, no motor weakness or sensory disturbance in the limbs, no bruit over the head, neck was supple with full flexion, slightly bloody cerebrospinal fluid, linear right temporal fracture, subarachnoid hematoma in the left sylvian fissure
Remission Characteristics
No longer demonstrable on the repeated angiogram after 35 days without any surgical intervention
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Conservative treatment
Additional Notes
The fistula was formed on the contralateral side to the head injury without a skull fracture. The patient's condition improved remarkably 34 days after the head injury.