CASE REPORT

Tentorial Subdural Hematoma: serie of cases and literature review

Hematoma Subdural Tentorial: série de casos e revisão de literatura

  • Carlos Umberto Pereira 1    Carlos Umberto Pereira 1
  • Lauro Roberto de Azevedo Setton 2    Lauro Roberto de Azevedo Setton 2
  • Ronald Alves Barcellos 3    Ronald Alves Barcellos 3
  • Tiago de Jesus Menezes 3    Tiago de Jesus Menezes 3
  • Antonio Carlos Silveira Azevedo 3
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Resumo

Introdução: o hematoma subdural tentorial é raramente relatado na literatura. A principal causa é o traumatismo cranioencefálico, seguido pela ruptura de aneurisma cerebral. A tomografia computadorizada (TC) é crucial para o diagnóstico. A condição geralmente tem um curso benigno, frequentemente manejado com tratamento conservador inicial. Métodos: descrevemos uma série de casos de dez pacientes diagnosticados com hematoma subdural tentorial agudo, admitidos no Hospital de Emergência João Alves (Aracaju, Sergipe, Brasil) entre 2012 e 2017. Foram avaliados fatores como idade, sexo, causa, tratamento e prognóstico. Resultados: dez pacientes com hematoma subdural tentorial foram analisados retrospectivamente. Sete eram do sexo masculino e três do sexo feminino, com idade média de 41 anos. A causa foi trauma em todos os casos. Tomografias computadorizadas do crânio foram realizadas em todos os pacientes. As lesões associadas incluíram: hematoma subdural supratentorial em dois pacientes, hematoma epidural em um, hemorragia subaracnoide em um e contusão cerebral em dois. Dois pacientes foram submetidos a tratamento cirúrgico: um para hematoma subdural supratentorial e um para hematoma epidural. Sete pacientes sobreviveram, com três apresentando déficits neurológicos residuais. Conclusão: o trauma é a principal causa de hematoma subdural tentorial. A TC de crânio é essencial para o diagnóstico e manejo. O tratamento conservador inicial geralmente resulta em um prognóstico favorável quando administrado de forma oportuna.

Palavras-chave

Hematoma subdural tentorial; Hematoma subdural agudo; Tentorial; Conduta

Abstract

Introduction: tentorial subdural hematoma has been poorly reported in the literature. The primary cause is traumatic brain injury, followed by cerebral aneurysm rupture. Computed tomography (CT) has been useful in diagnosis. It generally has a benign course, with initial conservative treatment. Methods: we describe a case series involving ten patients diagnosed with acute tentorial subdural hematoma admitted to the Emergency Hospital João Alves (Aracaju, Sergipe, Brazil) between 2012 and 2017. Aspects such as age, sex, cause, treatment, and prognosis were considered. Results: ten patients diagnosed with tentorial subdural hematoma were retrospectively analyzed. Seven were male and three were female. The mean age was 41 years. The cause was trauma in all patients. Cranial CT scans were performed in all cases. Associated injuries included supratentorial subdural hematoma in two patients, epidural hematoma in one, subarachnoid hemorrhage in one, and cerebral contusion in two. Two patients underwent surgical treatment, one for supratentorial subdural hematoma and one for epidural hematoma. Seven patients survived. Three patients had residual neurological deficits. Conclusion: the primary cause of tentorial subdural hematoma is trauma. Cranial CT has been useful in diagnosis and management. Initial treatment is conservative and generally leads to a good prognosis in most cases when addressed in a timely manner.


Keywords

Tentorial subdural hematoma; Acute subdural hematoma; Peritentorial; Treatment

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1Neurosurgery Service, Hospital de Urgência de Sergipe – HUSE, Fundação Hospital de Cirurgia, Aracaju, SE, Brasil.

2Otorhinolaryngology Service, Hospital Santo Antônio – Obras Sociais Irmã Dulce, Salvador, BA, Brasil.

3Neurosurgery Service, Hospital de Urgência de Sergipe – HUSE, Aracaju, SE, Brasil.

 

Received June 17, 2024

Accepted June 25, 2024

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