Spontaneous Disappearance of a Large Chronic Subdural Hematoma: A Pleasant Surprise

We report an extremely rare case of spontaneous complete disappearance of a large chronic subdural hematoma in a 78-year aged man with a significant mass effect and a large midline shift which was diagnosed around 6 weeks before admission. Repeat NCCT of the head in our department to everyone’s surprise revealed almost complete spontaneous resolution. Spontaneous resolution of a large chronic subdural hematoma is extremely rare, and the scarce literature whatsoever is available is especially in cases of immune thrombocytopenic purpura where steroids may play a role in the stabilization of neomembranes. Our interest is in this case because of the benign clinical course despite a large size causing severe mass effect and large midline shift. Chronic subdural hematoma is a common entity in the elderly generally seen weeks following minor trauma. Surgical evacuation of a chronic subdural hematoma remains the gold standard treatment, but controversy exists regarding the best surgical option. Spontaneous resolution of a chronic subdural hematoma has also been reported rarely, but mainly in patients with immune thrombocytopenic purpura.