Department of Neurosurgery, Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong 515041, China.
Med Hypotheses. 2013 Aug;81(2):159-62. doi: 10.1016/j.mehy.2013.05.019. Epub 2013 Jun 12.
Acute subdural hematoma (ASDH) is a severe insult with a high mortality rate, and emergent surgical evacuation is recommended in the vast majority of such cases. Generally, resolution of the hemorrhage requires weeks and months in patients treated conservatively. However, numerous cases of rapid spontaneous resolution of ASDH, occurring within 72h after the trauma, have been reported to date in the literature. Several possible hypotheses have been suggested, primarily involving redistribution and dilution, or washing out the ASDH. In this study, we present the relevant images of such a case, review the mechanisms of the rapid spontaneous resolution in the literature, and also propose a new hypothesis to explain the occurrence of the rapid spontaneous resolution of ASDH. We indicate that the fluctuation of intra-parenchymal cerebral pressure that drives the rapid spontaneous resolution of ASDH.
急性硬脑膜下血肿（ASDH）是一种严重的损伤，死亡率很高，绝大多数情况下建议紧急手术清除血肿。一般来说，接受保守治疗的患者需要数周甚至数月才能使血肿吸收。然而，目前文献中已经报道了许多创伤后 72 小时内迅速自发吸收的 ASDH 病例。已经提出了几种可能的假说，主要涉及再分布和稀释，或冲洗出 ASDH。在本研究中，我们展示了这样一个病例的相关图像，回顾了文献中 ASDH 迅速自发吸收的机制，并提出了一个新的假说来解释 ASDH 迅速自发吸收的发生。我们指出，脑实质内压力的波动驱动了 ASDH 的迅速自发吸收。
