[Acute spontaneous subdural hematoma--a case report (author's transl)].

In this paper a case of acute spontaneous subdural hematoma is reported with a review of fifteen cases in the literature. A 48-year-old left handed man suffered from severe headache on a motor cycle but he arrived at his brother's office immediately after. Three hours later he was found unconscious and soon he was brought to our hospital. On admission he was semicomatose with left hemiparesis. There was no evidences of head injury and the x-rays were normal. CT scan disclosed a high density mass in the left temporal extra-axial region with a remarkable shift of midline structures. His bleeding and clotting time were normal. Emergent left craniotomy was performed and a subdural clot without a membrane was evacuated. Neither cortical lacerations nor vascular malformations were seen on the cortical surface. But two spurting cortical arteries with a lateral pin-hole were seen and coagulated. Postoperative angiograms also revealed no vascular anomalies. He discharged one month later and he is now free from any neurological deficits. In the review several characteristic points of acute spontaneous subdural hematoma were discussed.