Cohen J E, Eger K, Montero A, Israel Z
Departamento de Neurocirugía, Hospital de Emergencias Dr. Clemente Alvarez, Rosario, Argentina.
Surg Neurol. 1998 Sep;50(3):241-4. doi: 10.1016/s0090-3019(97)00026-8.
The natural history of a traumatic acute subdural hematoma is usually interrupted by its prompt surgical removal. Rapid spontaneous resolution within 48 hours, although infrequently reported, may be, underestimated and demonstrates a benign course of this condition. To our knowledge, this is the first case of rapid spontaneous resolution of an acute subdural hematoma in a patient with HIV encephalopathy and cerebral atrophy.
This 27-year-old man, an intravenous drug user with AIDS-related complex and HIV encephalopathy, suffered an acute subdural hematoma due to head injury in a car accident. The hematoma spontaneously resolved within 12 hours, resulting in a favorable outcome with nonoperative treatment.
AIDS related cerebral atrophy may not only have predisposed the patient to the development of an extracerebral collection, but may have also favorably influenced the spontaneous resolution of the hematoma. The mechanism of the hematoma resolution and the influence of HIV related cerebral atrophy is discussed.
创伤性急性硬膜下血肿的自然病程通常会因及时的手术清除而中断。48小时内迅速自发消退的情况虽鲜有报道,但可能被低估了,并且表明这种情况病程良性。据我们所知,这是首例患有HIV脑病和脑萎缩的患者急性硬膜下血肿迅速自发消退的病例。
这名27岁男性为静脉吸毒者,患有艾滋病相关综合征和HIV脑病,在一次车祸中因头部受伤导致急性硬膜下血肿。血肿在12小时内自发消退,非手术治疗取得了良好效果。
与艾滋病相关的脑萎缩不仅可能使患者易发生脑外血肿,还可能对血肿的自发消退产生有利影响。本文讨论了血肿消退的机制以及HIV相关脑萎缩的影响。