Subacute subdural hematoma.

Abstract

The subacute subdural hematoma (SASDH) is an entity which is still to be analyzed because the attention of the clinicians was directed towards the acute subdural hematoma (ASDH) and to the chronic subdural hematoma (CSDH). A series of 69 patients with SASDH was studied outlining the particularities of the affection. A trauma caused the hematoma but it was a milder one. The associated cerebral lesions were generally produced by concussion (34%) and cerebral dilacerations represented only 8.4%. Clinical symptoms were obvious between the third and the fourteenth day after trauma due to the cerebral compression. The consciousness was moderately impaired. The patients with GCS < 8 represented 18.9%. The neurological picture stated with time allowed a programmed paraclinical investigation: a. radiography of the skull revealed cranial fractures in 10.1%; b. carotid arteriography showed a lentiform aspect of the avascular space; c. CT presented variable densities (isodensity--3%, hypodensity--14.5%, and hyperdensity--27.5%) depending on the length of the interval between trauma and admission. The operation evacuated the liquid blood collection through a widened burr hole. Death during operation was 17.4% and 79.8% survived.