Spontaneous resolution of traumatic acute subdural hematoma with good clinical outcome: A report of two cases

Post-traumatic acute subdural hematoma (ASDH) requires immediate surgical evacuation in most cases. We present two cases of ASDH which resolved spontaneously. The first patient had 9 mm thick ASDH in left fronto-temporo-parietal region with initial GCS of E1V1M3 which improved to E2VtM4 within 7 h. Repeat CT of the brain showed a decrease in the size of ASDH. Hence, patient was conservatively managed with anti-edema measures and elective ventilation. The patient improved and ASDH also resolved completely. The second patient also had 8 mm thick ASDH in the right fronto-temporo-parietal region with GCS of E1V2M5 which 5 h later improved to E3V4M5. With conservative measures, there was clinical and radiological improvement. Based on previous reports, certain characteristic features have been shown to favor spontaneous resolution of ASDH; absence of underlying contusion and the presence of a low-density band between the skull and the hematoma on imaging were features common to our patients also.