PMC10316227_01
Evolution of subdural hematoma (SDH) from presentation to 45 days later via head computed tomography (CT). (a) Head CT at initial presentation revealed a right-sided, mixed density 12 mm SDH with 12 mm midline shift to the left. (b) Cerebral angiogram visualizing middle meningeal artery. (c) Repeat head CT on hospital day 17 showing stable right SDH with resolving midline shift (5 mm to left).
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F1
Computed tomography of the head (hCT) revealed a right sided, mixed density 12 mm SDH with a 12 mm leftward midline shift and patchy acute subarachnoid hemorrhages [Figure 1a]. After receiving a total of 17 units of platelets, the patient underwent right eMMA with 150 microm of polyvinyl alcohol particles on hospital day 8 [Figure 1b]. Repeat hCT on hospital day 17 demonstrated a decreasing SDH [Figure 1c].
Graphical depiction of patient's platelet counts following initial presentation. The patient's platelet count ranged from <2000/mm3 at initial presentation up to 48,000 5 days after presentation following multiple platelet transfusions. He underwent eMMA 7 days after presentation with platelet count of 20,000. He was discharged on 23 days after presentation and received outpatient platelet transfusions 3 times a week with a platelet goal of 20,000. His average platelet count was 14,000.
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He continued to have platelet transfusions 3 times a week with an average platelet count of 14,000/microL [Figure 2].
Head magnetic resonance imaging 54 days after initial presentation of subdural hematoma (SDH). Sagittal and axial views of the right-sided hyperintense with patchy hypointense areas consistent with acute on chronic SDH.
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A hCT 30 days after discharge demonstrated a stable, panhemispheric acute on chronic SDH that was 15 mm in size with a 5 mm leftward midline shift [Figure 3].
PMC10316227_02
Preferred reporting items for systematic reviews and meta-analyses flow chart of systematic review conducted in October 2021. A total of 242 unique records were identified using PubMed and Web of Science databases. Initial title and abstract screening excluded 97 articles. Full-text screening found seven articles meeting inclusion criteria, n: Number.
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The PRISMA flow chart for the search strategy is depicted in [Figure 4].