急性硬膜下血肿快速自发消退并转化为硬膜下积液的机制
Mechanism for the Rapid Spontaneous Resolution of an Acute Subdural Hematoma and Transformation into a Subdural Hygroma.
作者信息
Gelsomino Michael, Awad Ahmed J, Gerndt Clayton, Nguyen Ha S, Doan Ninh, Mueller Wade
机构信息
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Faculty of Medicine and Health Sciences, An-Najah National University, Palestine.
出版信息
World Neurosurg. 2018 Jul;115:282-284. doi: 10.1016/j.wneu.2018.04.029. Epub 2018 Apr 13.
BACKGROUND
Spontaneous resolution of acute subdural hematomas (SDHs), occurring as the result of a traumatic injury, is well reported in the literature and rapidly resolving SDHs have been reported as well. Although the mechanism behind the rapid resolution of a SDH has not been well understood, there are postulated mechanisms for this phenomenon. The aim of this report is to present a patient who experienced the rapid resolution of a traumatic SDH, which was replaced by a subdural hygroma.
CASE DESCRIPTION
This 25-year-old man presented to the hospital with an acute left-sided SDH after a head-on motor vehicle collision. At the time of presentation, the patient had an acute SDH with 11 mm of midline shift. The hematoma resolved spontaneously within 48 hours and was replaced by a thin subdural hygroma.
CONCLUSIONS
Rapidly resolving SDHs represent a phenomenon that has been well described, although is not entirely understood. The imaging findings of this patient suggest that cerebrospinal fluid washout is a mechanism that promotes acute SDH resolution.
背景
创伤性损伤导致的急性硬膜下血肿（SDH）自发消退在文献中有充分报道，快速消退的SDH也有相关报道。尽管SDH快速消退背后的机制尚未完全明确，但针对这一现象有一些推测机制。本报告的目的是介绍一名经历了创伤性SDH快速消退并被硬膜下积液取代的患者。
病例描述
这名25岁男性在机动车迎面相撞后因急性左侧SDH入院。就诊时，患者急性SDH伴中线移位11毫米。血肿在48小时内自发消退，被一层薄的硬膜下积液取代。
结论
快速消退的SDH是一种虽已被充分描述但尚未完全理解的现象。该患者的影像学表现提示脑脊液冲洗是促进急性SDH消退的一种机制。
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