title: Spontaneous rapid resolution of acute subdural hematoma in children.
abstract: BACKGROUND
  Spontaneous rapid resolution of acute subdural hematoma developing secondary to trauma has been reported in the literature, yet it is very rare in pediatric population. The aim of the present review is to analyze mechanisms, characteristics, and outcomes of pediatric acute subdural hematoma cases with spontaneous rapid resolution in conjunction with an exemplary case of ours.
  
  
  METHODS
  A 3-year-old boy was admitted to our emergency department following mild head trauma secondary to a fall from 2 m. He was alert and has a GCS of 15. He had no motor or sensorial deficit on neurological examination. On the emergent brain computed tomography image, an acute subdural hematoma over left frontoparietal lobe was observed. There was a midline shift of 8.3 mm and the width of the hematoma at the thickest portion was 11.2 mm. Surgery was postponed with a close neurological follow-up of the patient in pediatric intensive care unit, due to his well neurological status without any increased ICP findings. On the fourth hour follow-up head CT image, amount of midline shift and hematoma thickness were observed to have regressed dramatically. At the second week, the hematoma resorbed totally with only conservative approach, and he was discharged to home in well status.
  
  
  CONCLUSIONS
  Analysis of 12 pediatric patients revealed a mean and median ages of 6.87 and 3.9 years, respectively (range = 8 months-18 years). Causes for ASH development were fall, traffic accident, struggle, and child abuse. Main clinical presentations were with depressed sensorium, coma, stupor, drowsiness, headache, motor weakness, lethargy, and seizure. Close follow-up with conservative treatment should be mode of approach in pediatric patients with ASH, if neurological and radiological findings are favorable. However, if patients' neurological status deteriorates after admission to hospital, surgery should be conveyed with no further delay.
authors.affiliation: Department of Neurosurgery, Batman State Hospital, Batman, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Öğrenci
authors.affiliation: Department of Orthopedic Surgery, Spine Center, University of California at San Francisco, 500 Parnassus Avenue, MU320 West, San Francisco, CA, 94143-0728, USA. muratsakireksi@gmail.com.
authors.forename: Murat Şakir
authors.initials: MŞ
authors.lastname: Ekşi
authors.affiliation: Department of Neurosurgery, Göztepe Medikal Park, İstanbul, Turkey.
authors.forename: Orkun
authors.initials: O
authors.lastname: Koban
authors.affiliation: Department of Neurosurgery, Batman State Hospital, Batman, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karakuş
mesh_terms: D002675:Child, Preschool; D019468:Disease Management; D020199:Hematoma, Subdural, Acute / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome
keywords: Acute subdural hematoma; Head trauma; Resolution