Rapid neurological recovery with spontaneous resolution of acute subdural hematoma after severe head trauma: A case report of auto-decompression phenomena

被引:0
作者
Obeng-Gyasi, Barnabas [1 ]
Chinthala, Anoop S. [1 ]
Christodoulides, Alexei [1 ]
Ordaz, Josue [1 ]
Mao, Gordon [1 ,2 ]
机构
[1] Indiana Univ Sch Med, Dept Neurol Surg, 340 W 10th St, Indianapolis, IN 46202 USA
[2] Indiana Univ Sch Med, Indiana Univ Hlth Neurosci Ctr, Dept Neurol Surg, Suite 5100, Indianapolis, IN 46202 USA
来源
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS | 2025年 / 127卷
关键词
Traumatic brain injury (TBI); Acute subdural hematoma (aSDH); Spontaneous resolution; Coagulopathy; Neurological recovery; Case Report; BRAIN-INJURY; EPIDEMIOLOGY; PATTERNS;
D O I
10.1016/j.ijscr.2025.110973
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: The spontaneous resolution of acute subdural hematoma (aSDH) represents an ill-defined but clinically significant phenomenon in traumatic brain injury (TBI). While surgical evacuation remains the standard of care for significant aSDH, rare cases of spontaneous resolution, termed auto-decompression in literature, suggest alternative pathways of hematoma clearance that warrant further investigation. Case presentation: We discuss the case of a 40-year-old male with background seizure disorder who fell off a ladder. His Glasgow Coma Score (GCS) at presentation was 5. Brain Computed Tomography (CT) scan revealed bilateral aSDH and multiple skull fractures. Within 24 h, his GCS quickly improved to 9 T. Repeat brain CT done 72 h post-trauma showed resolution of the aSDH following non-operative management. Discussion: Spontaneous resolution of bilateral aSDH with rapid neurological improvement is a rare but possible occurrence, often attributed to auto-decompression phenomenon in patients with severe head trauma and specific predisposing factors. Our discussion revolves around this patients presentation with polytrauma, complex skull fractures, history of craniotomy, and acute coagulopathy contributing to the spontaneous resolution of the hematoma. Given the complex nature of TBI and the unpredictable course of recovery, clinicians must remain vigilant in continuously reassessing neurological status. Conclusion: This case discusses the unpredictable nature of TBI and highlights the rapid and unexpected resolution of aSDH in a patient with complex neurosurgical history, coagulopathy, and polytrauma. The findings showcase the problems of polytraumatized patients and exemplify the importance of individualized care even when initial signs indicate poor prognosis.
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页数:5
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