Spontaneous resolution of traumatic acute subdural haematomas: A systematic review

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 24 h.

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: Brain haemorrhage; Hematoma subdural; Hemorragia cerebral; Subdural haematoma; Traumatic brain injury; Traumatismo craneal.