Case Report: Rapid Resolution of Acute Subdural Hematoma with Cerebral Herniation

Abstract Background Rapid Resolution of Acute Subdural Hematoma (RRASDH) is a special type of traumatic intracranial lesion. Reports of cases where elderly patients with post-traumatic acute subdural hematoma complicated by cerebral herniation achieve spontaneous rapid resolution of the hematoma in a short time are rare in the literature. Case presentation: An 87-year-old male presented with an accidental fall. Emergency cranial computed tomography (CT) revealed a subdural hematoma complicated by cerebral herniation. The patient had no special medical history and a Glasgow Coma Scale (GCS) score of 14, so symptomatic conservative treatment was administered. A follow-up CT scan 8 hours later showed hematoma absorption and improved midline shift, and the next day, CT demonstrated nearly complete hematoma resolution. Conclusion For patients with acute subdural hematoma (ASDH) who have initially acceptable neurological status and a clinically benign course—especially elderly patients—surgical decisions require careful consideration.