DOI QR코드

DOI QR Code

Rapid Spontaneous Redistribution of Acute Epidural Hematoma : Case Report and Literature Review

  • Eom, Ki-Seong (Department of Neurosurgery, Wonkwang University College of Medicine) ;
  • Park, Jong-Tae (Department of Neurosurgery, Wonkwang University College of Medicine) ;
  • Kim, Tae-Young (Department of Neurosurgery, Wonkwang University College of Medicine) ;
  • Kim, Jong-Moon (Department of Neurosurgery, Wonkwang University College of Medicine)
  • Published : 2009.02.28

Abstract

Acute epidural hematoma (AEDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. However, there are only several reports that show the rapid disappearance of AEDH without surgical intervention. We suggest redistribution of hematoma through the overlying skull fractures as the mechanism of rapid disappearance of AEDH. A 13-year-old female fell from a height of about 2 m and presented with mild headache. A computed tomography (CT) scan performed 4 hours after the injury revealed an AEDH with an overlying fracture in the right temporal region and acute small hemorrhagic contusion in the left frontal region. A repeat CT scan 16 hours after injury revealed that the AEDH had almost completely disappeared and showed an increase in the epicranial hematoma. The patient was discharged 10 days after injury with no neurological deficits. This case is characterized by the rapid disappearance of an AEDH associated with an overlying skull fracture. We believe that the rapid disappearance of the AEDH is due to the redistribution of the hematoma, rather than its resolution or absorption, and fracture plays a key role in this process.

Keywords

References

  1. Akagami R, Cochrane DD : Does it leak in or does it leak out. Pediatr Neurosurg 30 : 109-110, 1999 https://doi.org/10.1159/000028774
  2. Aoki N : Rapid resolution of acute epidural hematoma : report of two cases. J Neurosurg 68 : 149-151, 1988 https://doi.org/10.3171/jns.1988.68.1.0149
  3. Kang SH, Chung YG, Lee HK : Rapid disappearance of acute posterior fossa epidural hematoma. Neurol Med Chir (Tokyo) 45 : 462-463, 2005 https://doi.org/10.2176/nmc.45.462
  4. Kuroiwa T, Tanabe H, Takatsuka H, Arai M, Sakai N, Nagasawa S, et al : Rapid spontaneous resolution of acute extradural and subdural hematomas. Case report. J Neurosurg 78 : 126-128, 1993 https://doi.org/10.3171/jns.1993.78.1.0126
  5. Malek AM, Barnett FH, Schwartz MS, Scott RM : Spontaneous rapid resolution of an epidural hematoma associated with overlying skull fracture and subgaleal hematoma in a 17-month-old child. Pediatr Neurosurg 26 : 160-165, 1997 https://doi.org/10.1159/000121182
  6. Neely JC II, Jones BV, Crone KR : Spontaneous extracranial decompression of epidural hematoma. Pediatr Radiol 38 : 316-318, 2008 https://doi.org/10.1007/s00247-007-0652-5
  7. Pang D, Horton JA, Herron JM, Wilberger JE Jr, Vries JK : Nonsurgical management of extradural hematomas in children. J Neurosurg 59 : 958-971, 1983 https://doi.org/10.3171/jns.1983.59.6.0958
  8. Pozzati E, Tognetti F : Spontaneous healing of acute extradural hematoma : study of twenty-two cases. Neurosurgery 18 : 696-700, 1986 https://doi.org/10.1227/00006123-198606000-00003
  9. Servadei F, Staffa G, Pozzati E, Piazza G : Rapid spontaneous disappearance of an acute extradural hematoma : case report. J Trauma 29 : 880-882, 1989 https://doi.org/10.1097/00005373-198906000-00030
  10. Tuncer R, Açikbas C, Uçar T, Kazan S, Karasoy M, Saveren M : Conservative management of extradural haematomas : effects of skull fractures on resorption rate. Acta Neurochir (Wien) 139 : 203-207, 1997 https://doi.org/10.1007/BF01844752
  11. Ugarriza LF, Cabezudo JM, Fernandez-Portales I : Rapid spontaneous resolution of an acute extradural hematoma : case report. Br J Neurosurg 13 : 604-605, 1999 https://doi.org/10.1080/02688699943150

Cited by

  1. Benign Anterior Temporal Epidural Hematoma: Indolent Lesion with a Characteristic CT Imaging Appearance after Blunt Head Trauma vol.257, pp.1, 2010, https://doi.org/10.1148/radiol.10092075
  2. Spontaneous Slow Drainage of Epidural Hematoma Into the Subgaleal Space Through a Skull Fracture in an Infant vol.51, pp.12, 2009, https://doi.org/10.2176/nmc.51.854
  3. Spontaneous resolution of an acute epidural hematoma with normal intracranial pressure: case report and literature review vol.29, pp.11, 2009, https://doi.org/10.1007/s00381-013-2167-8
  4. „Verschwinden“ des Epiduralhämatoms im Verlauf vol.24, pp.5, 2009, https://doi.org/10.1007/s00194-014-0973-2
  5. Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature vol.16, pp.None, 2015, https://doi.org/10.12659/ajcr.895231
  6. Rapid Redistribution of an Acute Traumatic Epidural Hematoma in a Patient with Invasive Skull Cancer vol.14, pp.2, 2009, https://doi.org/10.13004/kjnt.2018.14.2.138
  7. Removal of a compressive mass causes a transient disruption of blood-brain barrier but a long-term recovery of spiny stellate neurons in the rat somatosensory cortex vol.39, pp.2, 2021, https://doi.org/10.3233/rnn-201085