Document Detail


Acute Spontaneous Subdural Hematoma in a Middle-Aged Adult: Case Report and Review of the Literature.
MedLine Citation:
PMID:  24915743     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Acute spontaneous subdural hematomas (ASSDH) occur by a variety of pathological processes and are less common than trauma-related acute subdural hematomas (SDH). Both types are usually seen in the elderly, and only 22 cases of ASSDH in patients aged < 40 years have been reported in the medical literature. Objectives: We report a rare case of ASSDH in a middle-aged male with no previous history of head trauma. A literature review comparing the clinical presentations, etiologies, incidence, mortality rates, and prognostic factors of ASSDH in various age groups is discussed.
CASE REPORT: A 37-year-old man presented to the Emergency Department with headaches, myalgias, and vomiting. Noncontrast computed tomography revealed a unilateral ASSDH with 9 mm of midline shift, despite a normal neurological examination. Upon admission, the patient developed an abducens palsy suggesting increased intracranial pressure and underwent an urgent hemicraniectomy. Pathological sampling revealed large atypical cells indicative of a hematopoietic neoplasm, but various advanced imaging modalities failed to identify signs of cerebral tumor, vascular malformation, or arterial extravasation.
CONCLUSION: Given the rarity of SDH in nonelderly patients, this case suggests a broader differential diagnosis for nontraumatic headaches to include arterial and even neoplastic origins. Our literature review confirms the paucity of reported incidences of ASSDH, yet reminds medical providers to closely monitor for developing neurological symptoms and initiate prompt medical intervention when necessary.
Authors:
Jaron B Coombs; Bryce L Coombs; Eric J Chin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-7
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  -     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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