Skip to main content

Subacute Subdural Hematoma

  • Conference paper
  • First Online:
Brain Edema XV


Subacute subdural hematoma (SASDH) is a rare entity. We retrospectively reviewed 8 patients with SASDH. Four patients were male and 4 were female, with an age range of 45–87 years (mean, 67.8 years). The minimal level of deterioration ranged from 8 to 14 (mean, 10.5). The deterioration of neurological symptoms was confirmed 4–20 days after injury (mean, 12.9). The hematoma volume was increased in 6 patients. Seven patients underwent surgeries (burr-hole irrigation in 6, craniotomy in 1). The Glasgow Outcome Scale indicated a good recovery in 4 patients and moderate disability in 4 patients. Increased cerebral blood flow was observed just below the SDH in 1 patient. We consider that the hypoperfused tissue in the acute phase might become hyperperfused during the subacute phase owing to impaired autoregulation, and the hyperperfusion may be responsible for the development of the SASDH, leading to deterioration. Further investigations in a larger series are needed to elucidate the mechanism underlying the development of SASDH.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions


  1. Abe M, Udono H, Tabuchi K, Uchino A, Yoshikai T, Taki K (2003) Analysis of ischemic brain damage in cases of acute subdural hematomas. Surg Neurol 59:464–472

    Article  PubMed  Google Scholar 

  2. Aoki N, Tsutsumi K (1990) Symptomatic subacute subdural haematoma following spontaneous acute subdural haematoma. Acta Neurochir (Wien) 102:149–151

    Article  CAS  Google Scholar 

  3. Aoki N, Oikawa A, Sakai T (1996) Symptomatic subacute subdural hematoma associated with cerebral hemispheric swelling and ischemia. Neurol Res 18:145–149

    PubMed  CAS  Google Scholar 

  4. Deibler AR, Pollock JM, Kraft RA, Tan H, Burdette JH, Maldjian JA (2008) Arterial spin-labeling in routine clinical practice, part 3: hyperperfusion patterns. AJNR Am J Neuroradiol 29:1428–1435

    Article  PubMed  CAS  Google Scholar 

  5. Ikeda K, Ito H, Yamashita J (1990) Relation of regional cerebral blood flow to hemiparesis in chronic subdural hematoma. Surg Neurol 33:87–95

    Article  PubMed  CAS  Google Scholar 

  6. Inao S, Kawai T, Kabeya R, Sugimoto T, Yamamoto M, Hata N, Isobe T, Yoshida J (2001) Relation between brain displacement and local cerebral blood flow in patients with chronic subdural haematoma. J Neurol Neurosurg Psychiatry 71:741–746

    Article  PubMed  CAS  Google Scholar 

  7. Izumihara A, Orita T, Tsurutani T, Kajiwara K (1997) Natural course of non-operative cases of acute subdural hematoma: sequential computed tomographic study in the acute and subacute stages. No Shinkei Geka 25:307–314

    PubMed  CAS  Google Scholar 

  8. Karasawa H, Naito H, Sugiyama K, Ueno J, Kin H, Oketa R (1995) Traumatic subacute subdural hematoma: possible mechanisms that cause their development. Jpn J Neurosurg 4:121–127

    Google Scholar 

  9. Mitchener A, Wyper DJ, Patterson J, Hadley DM, Wilson JT, Scott LC, Jones M, Teasdale GM (1997) SPECT, CT, and MRI in head injury: acute abnormalities followed up at six months. J Neurol Neurosurg Psychiatry 62:633–636

    Article  PubMed  CAS  Google Scholar 

  10. Morinaga K, Matsumoto Y, Hayashi S, Omiya N, Mikami J, Sato H, Inoue Y, Okawara S (1995) Subacute subdural hematoma: findings in CT, MRI and operations and review of onset mechanism. No Shinkei Geka 23:213–216

    PubMed  CAS  Google Scholar 

  11. Nishio M, Akagi K, Abekura M, Maeda Y, Matsumoto K (1998) A case of traumatic subacute subdural hematoma presenting symptoms arising from cerebral hemispheric edema. No Shinkei Geka 26:425–429

    PubMed  CAS  Google Scholar 

  12. Okuyama T, Saito K, Fukuyama K, Yamamoto K, Morimoto M, Aburano T (2000) Clinical study of cerebral blood flow in unilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT. No To Shinkei 52:141–147

    PubMed  CAS  Google Scholar 

  13. Salvant JB Jr, Muizelaar JP (1993) Changes in cerebral blood flow and metabolism related to the presence of subdural hematoma. Neurosurgery 33:387–393

    Article  PubMed  Google Scholar 

  14. Tanaka A, Yoshinaga S, Kimura M (1990) Xenon-enhanced computed tomographic measurement of cerebral blood flow in patients with chronic subdural hematomas. Neurosurgery 27:554–561

    Article  PubMed  CAS  Google Scholar 

  15. Teasdale E, Hadley DM (2005) Imaging the head injury. In: Reilly P, Bullock R (eds) Head injury: pathophysiology and management, 2nd edn. Hodder Educational, London, pp 169–214

    Google Scholar 

Download references

Conflict of Interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Satoru Takeuchi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Wien

About this paper

Cite this paper

Takeuchi, S. et al. (2013). Subacute Subdural Hematoma. In: Katayama, Y., Maeda, T., Kuroiwa, T. (eds) Brain Edema XV. Acta Neurochirurgica Supplement, vol 118. Springer, Vienna.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1433-9

  • Online ISBN: 978-3-7091-1434-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics