Los hematomas subdurales agudos constituyen una complicación relativamente frecuente de los traumatismos craneoencefálicos graves; en ocasiones son motivados por el sangrado procedente de la ruptura de un aneurisma o una malformación arteriovenosa. La presencia de un hematoma subdural agudo espontáneo de origen arterial, es decir sin una causa reconocible, es muy poco frecuente y existen controversias sobre su origen.
ObjetivosAnalizar los ocho casos de hematoma subdural agudo espontáneo de nuestro servicio diagnosticados en los últimos 19 años y realizar una revisión bibliográfica sobre su etiología.
ResultadosLa serie esta formada por dos mujeres y seis varones con una edad media de 52 años (rango 20–66). Clínicamente todos ellos presentaron disminución del nivel de consciencia y signos neurológicos focales. Los ocho pacientes fueron intervenidos quirúrgicamente y la mortalidad fue del 25%.
ConclusionesEl hematoma subdural agudo espontáneo es una entidad poco frecuente y cuyo pronóstico va a depender de la situación neurológica preoperatorio y de los antecedentes clínicos del paciente.
An acute subdural hematoma is often regarded as a complication of head trauma. Occasionally subdural bleeding from the rupture of a cerebral aneurysm or an arteriovenous malformations is described. Spontaneous subdural hematoma is, however, very rare and it commonly has an arterial origin and their aetiology is still a matter of controversy.
ObjectiveThe purpose of this paper is to present eight cases of spontaneous subdural hematoma seen at our department during the last 19 years. The etiological possibilities of spontaneous subdural hematoma are discussed.
Patients and methodsWe analyzed 8 cases of acute spontaneous subdural hematoma among a total number of 321 patients with subdural hematoma is presented.
ResultsThere were six males and 2 females with a mean age of 52 years (range 20–66). All patients developed progressive neurological deficits, until become comatose. All eight patients were operated on and surgical mortality was 25%.
ConclusionsSpontaneous subdural hematoma is a rare condition and the prognosis is mainly dependent on the pre-operative neurological state regardless of its origin or cause.
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