Spontaneous Acute Arterial Subdural Hematoma

Michael J Mulcahy; Joga Chaganti; Ashraf Dower; Darweesh Al-Khawaja

doi:10.1016/j.wneu.2017.11.152

Spontaneous Acute Arterial Subdural Hematoma

World Neurosurg. 2018 Feb:110:403-406. doi: 10.1016/j.wneu.2017.11.152. Epub 2017 Dec 2.

Authors

Michael J Mulcahy¹, Joga Chaganti², Ashraf Dower³, Darweesh Al-Khawaja³

Affiliations

¹ Department of Neurosurgery, Nepean Public Hospital, Sydney, Australia. Electronic address: mmulcahy@mqneurosurgery.com.
² Department of Radiology, Nepean Public Hospital, Sydney, Australia.
³ Department of Neurosurgery, Nepean Public Hospital, Sydney, Australia.

PMID: 29203309
DOI: 10.1016/j.wneu.2017.11.152

Abstract

Background: Spontaneous acute arterial subdural hematoma (SDH) is a rare entity caused by hemorrhage from a cortical perisylvian artery without a known precipitant.

Case description: A 53-year-old man presented with a 2-day history of acute-onset headache and dysphasia. He had a generalized seizure on arrival to hospital and no history of trauma. A computed tomography demonstrated an acute left-sided SDH. A computed tomography angiogram and a digital subtraction angiogram demonstrated active contrast extravasation into the SDH. A craniotomy was performed to evacuate the hematoma; the bleeding perisylvian artery was visualized and coagulated.

Conclusions: We report a rare case of acute SDH and present a review of the literature. The etiology, investigation, and management of this rare neurosurgical emergency are discussed.

Keywords: Acute subdural hematoma; Cerebral arteries; Contrast extravasation; Spontaneous.

Publication types

Case Reports

MeSH terms

Cerebral Angiography
Cerebral Arterial Diseases / diagnostic imaging*
Cerebral Arterial Diseases / surgery
Diagnosis, Differential
Hematoma, Subdural, Acute / diagnostic imaging*
Hematoma, Subdural, Acute / surgery
Humans
Male
Middle Aged
Tomography, X-Ray Computed