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Vol. 27. Num. 3.May - June 2016Pages 103-154
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Vol. 27. Num. 3.May - June 2016Pages 103-154
Review article
DOI: 10.1016/j.neucir.2015.05.003
Spontaneous resolution of traumatic acute subdural haematomas: A systematic review
Resolución espontánea de hematoma subdural agudo traumático: una revisión sistemática
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Roberto Bezerra Vital
Corresponding author
roberto_vital@hotmail.com

Corresponding author.
, Pedro Tadao Hamamoto Filho, Victor Azevedo de Oliveira, Flávio Ramalho Romero, Marco Antônio Zanini
Botucatu Medical School; UNESP Univ Estadual Paulista; Department of Neurology, Psychology and Psychiatry, Botucatu, SP, Brazil
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Table 1. TASDH with spontaneous improvement in less than 24h.
Abstract
Introduction

Traumatic subdural haematomas often require emergency surgical evacuation. Spontaneous resolution of traumatic acute subdural haematomas (TASDH) is under-reported. Two patients are described with spontaneous resolution of TASDH correlating with previous reports. A discussion is presented on the clinical, pathological and radiological features of TASDH.

Methods

A review of the literature was performed using PubMed (Medline), Embase, and Cochrane Library for similar cases.

Results

A total 21 articles were included, involving 27 cases well detailed of TASDH with spontaneous resolution or neurological and radiological improvement in less than 24h.

Conclusions

There are two main mechanisms for the spontaneous resolution of acute subdural haematomas: dilution in subarachnoid space and redistribution of the haematoma in the subdural space. The primary radiological characteristic of these lesions is a hypodense rim on the outer surface of the clot. Spontaneous resolution of TASDH is unusual. Clinical and radiological surveillance is essential for appropriate management of these patients.

Keywords:
Traumatic brain injury
Subdural haematoma
Brain haemorrhage
Resumen
Introducción

Los hematomas subdurales agudos traumáticos (HSDAT) requieren tratamiento quirúrgico de urgencia. Muy raras veces se describen casos de resolución espontánea de HSDAT. Describimos 2 casos de resolución espontánea de HSDAT y revisamos la bibliografía pertinente. Se discuten los aspectos clínicos, patológicos y radiológicos de resolución espontánea de HSDAT.

Métodos

Revisamos la literatura en Pubmed (Medline), Embase y Cochrane Library en busca de casos similares.

Resultados

Se incluyeron 21 artículos con 27 casos bien detallados de HSDAT con resolución espontánea o mejora clínica y radiológica en 24h.

Conclusiones

Existen 2 mecanismos principales para la resolución espontánea de hematomas subdurales agudos: la dilución en el espacio subaracnoideo y la redistribución del hematoma en el espacio subdural. La principal característica radiológica de estas lesiones es una cerco hipodenso en la superficie exterior del coágulo. La resolución espontánea de HSDAT es rara. La vigilancia clínica y radiológica es esencial para el manejo adecuado de estos pacientes.

Palabras clave:
Traumatismo craneal
Hematoma subdural
Hemorragia cerebral

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