自然消退傾向を示した後に急激に増大した急性硬膜下血腫の一例

抄録

77 year-old woman had a traffic accident. When she was taken to our hospital, she had no neurological deficit. Computed tomography (CT) scan on adimission showed acute subdural hematoma, and we selected conservative management. On the following morning, CT scan showed spontaneous remission of the hematoma and she had no symptom. However in the night at the same day, she presented with severe consiousness disturbance and CT scan revealed significant expansion of the hematoma. Hematoma removal was performed immedeately, and we found intraoperatively that the bleeding point was a peripheral branch of the cortical artery. This is a rare case which having both two phenomenons; spontaneous remission and rapid expansion of the subdural hematoma in the acute phase. We considered the mechanism of this clinical condition with some review of the literature.