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Rapid Spontaneous Regression Of Traumatic Subdural Hematoma

Punia, P. 2024Other/Unknown

Punia, P., Chugh, A., Gotecha, S., Singh, N., Gaud, J., Rege, I., & Aziz, R. A. (2024). Rapid Spontaneous Regression of Traumatic Subdural Hematoma. Journal of emergencies, trauma, and shock, 17(4), 245–247. https://doi.org/10.4103/jets.jets_46_24

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Abstract

Acute subdural hematoma (ASDH) is a type of intracranial hemorrhage and is due to the collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane. It tends to occur in the temporal parietal regions. Early intervention is the key for better outcome of the patient. Management depends on neurological status and imaging. Large SDH collects along the convexity of the brain causing compression over the brain stem with midline shift. In cases of conservatively managed ASDH, spontaneous resolution usually takes weeks to months depending on the size of the bleed. In rare cases, spontaneous rapid resolution of the SDH occurs. So here, we are presenting an 11-month-old baby girl who was brought to our Emergency room/department (ER) with a history of fall and computed tomography scan was suggestion of an ASDH in the left temporoparietal region which resolves on its own in 6 h which is a rare phenomenon and needs to be highlighted.

Case Details

Disease Location

Brain

Personal Characteristics

11-month-old baby girl

Clinical Characteristics

Brought to the er with a history of a fall while playing at home within 3 hours and presented with seizures. CT scan was done suggestive of a crescent shape hyperdense collection of maximum thickness 10 mm in the left fronto-temporoparietal region with no significant midline shift and mass effect. Mannitol 5 cc/kg/day and levetiracetam 20 mg/kg/day were given

Remission Characteristics

Repeat CT after 6 hours at 5 am showed that subdural hematoma which was present on the first CT scan had significantly regressed in size

Treatment & Mechanisms

Proposed Remission Mechanisms

May be due to the redistribution of the hematoma into the subarachnoid spaces and the spinal subdural space.

Clinical Treatment

Mannitol, levetiracetam

Non-Clinical Treatment

None reported