title: Redistribution of hematoma to spinal subdural space as a mechanism for the rapid spontaneous resolution of posttraumatic intracranial acute subdural hematoma: case report.
abstract: BACKGROUND
  Rapid spontaneous resolution of posttraumatic intracranial ASDH has been reported in the literature since 1986. We report a case to demonstrate that redistribution of hematoma to the spinal subdural space is a mechanism for the rapid spontaneous resolution of posttraumatic intracranial ASDH.
  
  
  METHODS
  A 73-year-old woman with a slipped-and-fell injury had a worst GCS score of 8/15. Computerized tomography of the brain demonstrated a large intracranial ASDH with mass effect. Conservative management was decided because of her poor premorbid general condition. Rapid clinical improvement was observed within 5 hours after the CT. Progress CT of the brain at 45 hours postinjury showed that the size of the intracranial ASDH was markedly diminished. The CT findings apparently demonstrated a caudal distribution of the intracranial ASDH over the tentorium and then into the posterior fossa. To investigate this further, an MRI of the spine was performed, which showed that there was spinal SDH in the cervical and thoracic spine.
  
  
  CONCLUSIONS
  This is the first report demonstrating that redistribution of posttraumatic intracranial ASDH to the spinal subdural space is one of the mechanisms behind the rapid spontaneous resolution of posttraumatic intracranial ASDH in the acute phase.
authors.affiliation: Department of Neurosurgery, Tuen Mun Hospital, Tuen Mun, Hong Kong. wongsuito@hotmail.com
authors.forename: Sui To
authors.initials: ST
authors.lastname: Wong
authors.forename: Ming Keung
authors.initials: MK
authors.lastname: Yuen
authors.forename: Kam Fuk
authors.initials: KF
authors.lastname: Fok
authors.forename: Shing Chau
authors.initials: SC
authors.lastname: Yuen
authors.forename: Kwong Yui
authors.initials: KY
authors.lastname: Yam
authors.forename: Dawson
authors.initials: D
authors.lastname: Fong
mesh_terms: D000058:Accidental Falls; D000368:Aged; D003388:Cranial Fossa, Posterior / Q000473:pathology; D005260:Female; D015600:Glasgow Coma Scale; D020199:Hematoma, Subdural, Acute / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D012559:Schizophrenia / Q000150:complications; D013116:Spinal Cord / Q000473:pathology*; D014057:Tomography, X-Ray Computed