Acute subdural hematoma
An acute subdural hematoma (SDH) is a rapidly clotting blood collection below the inner layer of the dura but external to the brain and arachnoid membrane.
Subdural hematomas may be mixed in nature, such as when acute bleeding has occurred into a chronic subdural hematoma.
Types
Intracranial acute traumatic subdural hematoma
Intracranial acute spontaneous subdural hematoma
Clinical features
Clinically evident or subclinical seizures are common manifestation in acute subdural hematoma (aSDH); however, there is a paucity of research investigating the relationship between seizures and aSDH.
Diagnosis
see Acute subdural hematoma diagnosis.
Differential diagnosis
Hyperdense enhancing subdural effusion due to contrast extravasation has been recently described as a potential mimicker of acute subdural hematoma following a percutaneous coronary procedure.
Zamora and Lin report on 2 patients who presented with subarachnoid hemorrhage from ruptured cerebral aneurysms and who developed enhancing subdural effusions mimicking acute subdural hematomas after angiography and endovascular coil placement. In 1 case, the subdural effusions completely cleared but recurred after a second angiography. CT attenuation values higher than expected for blood, as well as the evolution of the effusions and density over time, allowed for differentiation of enhancing subdural effusions from acute subdural hematomas 1).
Treatment
see Acute subdural hematoma treatment.
Outcome
Acute subdural hematoma outcome.
Case series
see Acute subdural hematoma case series.
Case reports
2015
A 24-year-old female was admitted because of right sided partial seizure and acute or subacute subdural hematoma over the left cerebral convexity. She had no history of recent head trauma but performed headbanging at a punk rock concert at 3 days before admission. Since, she had a previous acute subdural hematoma on the same side after an accidental fall from a baby buggy when she was 11 months old, the present was recurrent subdural hematoma probably due to headbanging.
Headbanging has the hazardous potential to cause a subdural hematoma 2).