Rapid Spontaneous Resolution of Acute Epidural Hematoma: A Case Report and Review of the Literature

Abstract

Background: Epidural hematomas (EDH) are pathologiesin which the early diagnosis and treatmentare important. Resolution under 24 hours is very rare.Case Report: An 11-month-old male patient wasbrought to the emergency department with head traumafrom falling out of bed onto his back. There wereno neurological deficits, except for the patient beingsomnolent. Computed tomography (CT) of the patientrevealed subgaleal edema in the right parietal region,linear fracture and image consistent with EDH with athickness of about 9 mm underneath fracture. A controlCT was performed after 3 hours as somnolencecontinued in follow-up of the patient. Hematoma inthe epidural region was observed to completely resolveand edema in the subgaleal region was observedto gain hemorrhagic characteristics.Conclusion: In total, 15 cases have been reported, includingour case, in the literature with resolution lessthan 24 hours. Our case has the fourth fastest resolutionever reported in the English literature. We thinkthat the most important factor in the rapid spontaneousresolution is the presence of a connection betweenthe epidural and epicranial space, either through afracture or cranial sutures.