Objective: Acute sub dural hematomas (ASDH) are one of the most common sequel following traumatic brain injury. Most of the ASDH constitutes neurosurgical emergency requiring urgent evacuation of the hematoma. There are very few and rare instances of Spontaneous and rapid resolution of ASDH. We share our experiences of Patients having spontaneous resolution of ASDH in a view to establish the pathophysiology & predicting factors and to improve the management of ASDH.Patients & Methods: We retrospectively analyzed Clinical & radiological findings as well as outcomes of 8 patients having ASDH who had spontaneous and rapid resolution. Result: Certain predicting factors such as, presence of cerebrospinal fluid (CSF) band or sub duralhygro-hematoma, large CSF spaces in computed tomography (CT) brain were consistent with these patients. Conclusion: Spontaneous & rapid resolution of ASDH though rare, is a possibility even in a patient with thick ASDH with significant midline shift. A repeat CT before surgery should be done especially in neurologically improving patients. Presence of the CSF band or sub duralhygro- hematoma/large CSF spaces in CT brain maybe a guide in identifying such patients and to avoid high risk surgery.

Keywords: Acute Sub dural hematoma; Spontaneous Resolution; Head Injury; CSF Band.