Acta Neurochirurgica

, Volume 160, Issue 7, pp 1311–1314 | Cite as

Case report on the spontaneous resolution of a traumatic intracranial acute subdural haematoma: evaluation of the guidelines

  • Isabel Charlotte Hostettler
  • Srinivas Murahari
  • Muhammad H. Raza
  • Vassilios Kontojannis
  • Kevin Tsang
  • Haider Kareem
  • Brynmor Jones
  • Mark Wilson
Case Report - Brain Injury


Rapid spontaneous resolution of traumatic acute subdural haematomas (ASDH) can occur but is rare. We present an 88-year-old female who presents with a large left acute subdural haematoma (ASDH) measuring 18 mm in thickness with midline shift of 10.7 mm. We managed her conservatively based upon good consciousness level and absent neurological deficits. Repeat computed tomography (CT) the following day demonstrated near complete resolution of the ASDH and midline shift regression; a further CT confirmed resolution. Most patients with large ASDH require surgical evacuation; however, in rare cases, they can resolve spontaneously with extreme rapidity. Conservative management can be a valid option in carefully selected cases.


Acute subdural haematoma Midline shift Conservative management Spontaneous resolution 



Acute subdural haematoma


Brain Trauma Foundation


Cerebral spinal fluid


Computed tomography


Glasgow Coma Scale


Midline shift


Magnetic resonance imaging


Traumatic brain injury



We thank the patient for allowing us to present this case.

Compliance with ethical standards


The patient has consented to the submission of the case report for submission to the journal.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Isabel Charlotte Hostettler
    • 1
  • Srinivas Murahari
    • 1
  • Muhammad H. Raza
    • 1
  • Vassilios Kontojannis
    • 1
  • Kevin Tsang
    • 1
  • Haider Kareem
    • 1
  • Brynmor Jones
    • 2
  • Mark Wilson
    • 1
  1. 1.Imperial Neurotrauma Centre, Neurosurgery Department, St. Mary’s HospitalImperial College NHS TrustLondonUK
  2. 2.Imperial Neurotrauma Centre, Neuroradiology Department, St. Mary’s HospitalImperial College NHS TrustLondonUK

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