Delayed acute subdural hematoma
Kaiser R., Zvěřina E., Pachl J., Haninec P.
The development of acute subdural haematoma occurs typically soon after a head trauma and its presence shows on CT scan immediately after admission. Spontaneous haematomas are also described, especially those associated with coagulopathies, as well as delayed haematomas occurring with latency after a known head injury. A group of 116 patients who had suffered from acute subdural haemorrhage was analyzed retrospectively. Most of them (96.6%) were operated upon soon after admission. In four cases (3.4%), a deterioration of clinical status occurred after an interval of 1-4 days. Second CT scans revealed the development of delayed acute subdural haemorrhage and all of them were operated upon immediately. The first CT was negative only in one case; subarachnoid haemorrhage or skull fracture was found in three cases. Two patients were given warfarin, one was thrombocytopenic and another had serious hepatic coagulopathy.