Delayed Acute Subdural Hematoma

Česká verzia

Authors: R. Kaiser ¹; E. Zvěřina ¹; J. Pachl ²; P. Haninec ¹
Authors place of work: 3. LF UK a FN Královské Vinohrady, Praha Neurochirurgická klinika ¹; 3. LF UK a FN Královské Vinohrady, Praha Klinika anesteziologie a resuscitace ²
Published in the journal: Cesk Slov Neurol N 2011; 74/107(4): 455-458
Category: Short Communication

Summary

The development of acute subdural haematoma occurs typically soon after a head trauma and its presence shows on CT scan immediately after admission. Spontaneous haematomas are also described, especially those associated with coagulopathies, as well as delayed haematomas occurring with latency after a known head injury. A group of 116 patients who had suffered from acute subdural haemorrhage was analyzed retrospectively. Most of them (96.6%) were operated upon soon after admission. In four cases (3.4%), a deterioration of clinical status occurred after an interval of 1–4 days. Second CT scans revealed the development of delayed acute subdural haemorrhage and all of them were operated upon immediately. The first CT was negative only in one case; subarachnoid haemorrhage or skull fracture was found in three cases. Two patients were given warfarin, one was thrombocytopenic and another had serious hepatic coagulopathy.

Key words:
delayed subdural hematoma – spontaneous subdural hematoma – acute subdural hematoma

Zdroje

1. Jones NR, Blumbergs PG, North JB. Acute subdural haematomas: etiology, patology and outcome. Aust NZJ Surg 1986; 56: 907–913.

2. Juráň V, Smrčka M, Svoboda K, Fadrus P, Šprláková A, Gál R. Indikace dekompresivní kraniektomie u traumat mozku. Cesk Slov Neurol N 2009; 72/105(5): 439–445.

3. Houdek M, Kala M, Heřman M. Interhemispheric subdural haematoma. Cesk Slov Neurol N 1996; 59/92(4): 338–340.

4. Westermaier T, Eriskat J, Kunze E, Günthner-Lengsfeld T, Vince GH, Roosen K. Clinical features, treatment, and prognosis of patients with acute subdural hematomas presenting in critical condition. Neurosurgery 2007; 61(3): 482–487.

5. Oikawa A, Aoki N, Sakai T. Arteriovenous malformation presenting as acute subdural haematoma. Neurol Res 1993; 15(5): 353–355.

6. Akioka N, Fukuda O, Takaba M, Kameda H, Saito T, Endo S. Clinical investigation of acute spontaneous subdural hematoma cases. J Stroke Cerebrovasc Dis 2007; 16(3): 109–113.

7. Bongioanni F, Ramadan A, Kostli A, Berney J. Acute subdural hematoma of arteriolar origin. Traumatic or spontaneous? Neurochirurgie 1991; 37(1): 26–31.

8. Crooks DA. Pathogenesis and biomechanics of traumatic intracranial haemorrhages. Virchows Arch A Pathol Anat Histopathol 1991; 418(6): 479–783.

9. Itshayek E, Rosenthal G, Fraifeld S, Perez-Sanchez X, Cohen JE, Spektor S. Delayed posttraumatic acute subdural hematoma in elderly patients on anticoagulation. Neurosurgery 2006; 58(5): 851–856.

10. Piepmeier JM, Wagner FC jr. Delayed post-traumatic extracerebral hematomas. J Trauma 1982; 22(6): 455–460.

11. 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(2): 461–463.

12. Iuvara-Bommeli A, de Tribolet N. Delayed intracranial hematomas following cranio-cerebral trauma. Schweiz Med Wochenschr 1991; 121 (18): 646–652.

13. Russel N, DeJong MD. Delayed traumatic intracerebral hemorrhage. Arch Neurol Psychiatry 1942; 48(2):257–266.

14. Ivascu FA, Howells GA, Junn FS, Bair HA, Bendick PJ, Janczyk RJ. Rapid warfarin reversal in anticoagulated patients with traumatic intracranial hemorrhage reduces hemorrhage progression and mortality. J Trauma 2005; 59(5): 1131–1139.