Acute-on-chronic subdural hematoma

• Middle Meningeal Artery (MMA) Embolization for Recurrent Subacute Subdural Hematoma With Complete Resolution Following Transient Radiological Size Progression: A Case Report and Literature Review
• Palliative middle meningeal artery embolisation for symptomatic chronic subdural haematoma in an individual with resistant thrombocytopaenia due to acute myeloid leukaemia
• Prophylactic anticoagulation in traumatic subdural hematoma
• Transient enhancement of chronic subdural hematomas: a clinical report of a mimic of acute intracranial hemorrhage
• An autopsy case of encapsulated acute subdural hematoma presenting as an acute-on-chronic spontaneous subdural hematoma
• A Rare Case of Systemic Cystic Angiomatosis in an Elderly Female Initially Misdiagnosed as Vascular Neoplasm: A Case Report and Literature Review
• Cost-minimizing thresholds and recurrence rates in surgical evacuation with adjunctive middle meningeal artery embolization versus evacuation alone
• A case of recurrent subdural hematoma after unilateral MMA embolization that resolved after contralateral MMA embolization

Acute-on-chronic subdural hematoma (SDH) is a new hemorrhage on a preexisting hematoma in the space between the dura mater and the arachnoid layer. Although chronic SDH is common, acute-on-chronic SDH is not.

A 70-year-old male with ischemic heart disease, diabetes mellitus, and hypertension presented with worsening headaches for the past three days, associated with gait imbalance and dizziness. The patient was vitally stable on examination with a Glasgow Coma Scale/Score (GCS) of 15/15; his pupils were reactive bilaterally; and his neurological examination was unremarkable. Non-contrast computed tomography (CT) of the head yielded acute and chronic SDH. The patient was initially managed by embolization of the middle meningeal artery (EMMA), but one day later he developed a stroke. Hence, thrombectomy and burr hole craniotomy were performed to manage the stroke and evacuate the chronic subdural hematoma (CSDH). This paper presents this case as uncommon acute on chronic SDH presented with headache and vertigo, treated with embolization and with complications of stroke and pulmonary embolism ¹⁾.

Acute-on-Chronic Subdural Hematoma Causing Uncal Herniation ²⁾.