Acute subdural haematoma: a rare but crucial diagnosis

• Autor(a) principal: Casado, André
• Data de Publicação: 2008
• Outros Autores: Pacheco Pereira, João, Reis Pina, Paulo, Silva, Francisco, Pimenta da Graça, J. M.
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1474
• topic: Hematoma sub-dural agudo espontâneo; enoxaparina; heparinas de baixo peso molecular; acute spontaneous subdural haematoma; enoxaparin; low molecular weight heparins

Acute sub-dural haematoma (ASDH) is a common neurosurgical emergency with high morbidity and mortality. In the vast majority of cases it is associated with head trauma but it can occur in non-traumatic settings (spontaneous ASDH). These cases are very rare and have been associated with cortical artery lesions, hipocoagulability and the ingestion of drugs. Antiplatelet and anticoagulant drugs are clearly established risk factors for ASDH in traumatic as well as spontaneous cases.The authors present a case of ASDH in an in-patient who’s only identified risk factor was the administration of a prophylactic doses of enoxaparin. We reviewed the literature on the subject and present a discussion on the causes of spontaneous ASDH with a special emphasis on anticoagulant treatment as a risk factor. We did not found any references for low molecular weight heparins in prophylactic regimes, as possible cause, for this kind of event.This case reminds us that, although rare, this entity must be considered even in the absence of head trauma, as early diagnosis and intervention may prevent a negative outcome