Rapid Spontaneous Resolution of Acute Epidural Hematoma: A Case Report and Review of the Literature
Rapid Spontaneous Resolution of Acute Epidural Hematoma: A Case Report and Review of the Literature
Background: Epidural hematomas (EDH) are pathologiesin which the early diagnosis and treatmentare important. Resolution under 24 hours is very rare.Case Report: An 11-month-old male patient wasbrought to the emergency department with head traumafrom falling out of bed onto his back. There wereno neurological deficits, except for the patient beingsomnolent. Computed tomography (CT) of the patientrevealed subgaleal edema in the right parietal region,linear fracture and image consistent with EDH with athickness of about 9 mm underneath fracture. A controlCT was performed after 3 hours as somnolencecontinued in follow-up of the patient. Hematoma inthe epidural region was observed to completely resolveand edema in the subgaleal region was observedto gain hemorrhagic characteristics.Conclusion: In total, 15 cases have been reported, includingour case, in the literature with resolution lessthan 24 hours. Our case has the fourth fastest resolutionever reported in the English literature. We thinkthat the most important factor in the rapid spontaneousresolution is the presence of a connection betweenthe epidural and epicranial space, either through afracture or cranial sutures.
___
- 1. Pang D, Horton JA, Herron JM, Wilberger JE, Vries JK. Nonsurgical management of extradural hematomas in children. J Neurosurg 1983;59:958-71. [CrossRef]
- 2. Aoki N. Rapid resolution of acute epidural hematoma. Report of two cases. J Neurosurg 1988; 68:149-51. [CrossRef]
- 3. Servadei F, Staffa G, Pozzati E, Piazza G. Rapid spontaneous disappearance of an acute extradural hematoma: case report. J Trauma 1989;29:880-2. [CrossRef]
- 4. Malek AM, Barnett FH, Schwartz MS, Scott RM. Spontaneous rapid resolution of an epidural hematoma associated with an overlying skull fracture and subgaleal hematoma in a 17-monthold child. Pediatr Neurosurg 1997;26:160-5. [CrossRef]
- 5. Ugarriza LF, Cabezudo JM, Fernandez-Portales I. Rapid spontaneous resolution of an acute extradural hematoma: case report. Br J Neurosurg 1999;13:604-5. [CrossRef]
- 6. Neely JC 2nd, Jones BV, Crone KR. Spontaneous extracranial decompression of epidural hematoma. Pediatr Radiol 2008;38:316-8. [CrossRef]
- 7. Eom K, Park J, Kim T, Kim J. Rapid spontaneous redistribution of acute epidural hematoma: case report and literature review. J Korean Neurosurg Soc 2009;45:96-8. [CrossRef]
- 8. Dolgun H, Türkoğlu E, Kertmen H, Yılmaz ER, Ergun BR, Sekerci Z. Rapid resolution of acute epidural hematoma: case report and review of the literature. Ulus Travma Acil Cerrahi Derg 2011;17:283-5. [CrossRef]
- 9. Gülşen I, Ak H, Sösüncü E, Yavuz A, Kiymaz N. Spontaneous rapid resolution of acute epidural hematoma in childhood. Case Rep Med 2013;2013:956849. [CrossRef]
- 10. Tataryn Z, Botsford B, Riesenburger R, Kryzanski J, Hwang S. Spontaneous resolution of an acute epidural hematoma with normal intracranial pressure: case report and literature review. Childs Nerv Syst 2013;29:2127-30. [CrossRef]