Akira Toriyama, the renowned Japanese manga artist, passed away on March 1 at the age of 68 due to an acute subdural hematoma. His iconic work, “Dragon Ball,” has sold over two billion copies worldwide, with the animated series of the same name airing in over 80 countries and amassing a large global fan following.
Takashi Matsuyama, a former assistant of Akira Toriyama confirmed that Mr. Toriyama had told him he would undergo brain tumor surgery earlier this year. According to Dr. Kuo-Chen Wei, a prominent neurosurgeon and professor at Chang Gung Memorial Hospital in Taiwan, acute subdural hematomas are rare and can result from spontaneous or traumatic events. If this complication occurs after surgery, it might be due to a previous brain tumor hemorrhage, which could lead to the formation of a blood clot.
Research has indicated that spontaneous subdural hematomas are less common than traumatic ones. The main causes include rupture of the cortical arteries, vascular malformation, aneurysm, and tumors. Among them, 5.4 percent of spontaneous subdural hematoma cases are related to brain tumors, particularly in middle-aged adults.
What Is Acute Subdural Hematoma?
Subdural hematoma is a type of intracranial hemorrhage that includes acute, subacute, and chronic forms. An acute subdural hematoma is a blood clot that develops between the brain’s surface and the dura mater, often caused by stretching and tearing of the veins on the brain’s surface. When the head is injured, the brain undergoes a sudden jolt or shaking, causing these veins to rupture. This type of traumatic acute subdural hematoma is among the most fatal of all head injuries.
According to the Mayo Clinic, even mild head trauma can lead to intracranial hemorrhage in adults. Symptoms of intracranial hemorrhage may appear immediately after a head injury or take several weeks or even longer to develop.
As time passes, the pressure on the brain increases, leading to symptoms such as worsening headache, dizziness, vomiting, confusion, slurred speech, seizures, drowsiness, and loss of consciousness.
Treatment and Prognosis
Acute subdural hematoma often necessitates immediate surgical intervention to remove the hematoma and alleviate pressure within the skull. However, the outcomes of these surgeries and the prognosis for patients are generally unfavorable.A study published in The New England Journal of Medicine in 2023 analyzed 426 patients with acute subdural hematoma from 11 countries. They were split into two groups: one group underwent craniotomy, and the other underwent decompressive craniectomy. In evaluating the patients one-year post-surgery, researchers found similar outcomes in both groups. The mortality rates for craniotomy and decompressive craniectomy were 30.2 percent and 32.2 percent, respectively. Rates for vegetative state were 2.3 percent and 2.8 percent, for severe disability were 17.7 percent and 19.4 percent. Rates for good recovery were 25.6 percent and 19.9 percent, respectively.
Another study tracked 84 individuals aged 65 or older who underwent craniotomy for acute or subacute subdural hematoma between 2000 and 2015. Over the 16-year follow-up period, 25 percent regained functional independence, 11 percent were severely disabled, and 64 percent passed away.
5 High-Risk Groups Identified by Experts
Dr. Sing-Soon Sam, a resident neurosurgeon at the neurosurgery department of Far Eastern Memorial Hospital in Taiwan, highlighted in an article on the hospital’s website that acute subdural hematoma is often linked to a history of significant head trauma, with symptoms emerging rapidly and severely. He emphasized the importance of seeking immediate medical attention if any trauma results in acute symptoms to receive optimal diagnosis and treatment within the critical early period. Additionally, following the physician’s instructions for rehabilitation can help minimize damage to the body.Dr. Wei pointed out five high-risk groups that should be particularly cautious about subdural hematoma:
- Those who have experienced severe falls
- Those who have experienced head injuries
- The elderly
- People with hypertension
- Diabetics
The researchers also found that diabetic patients with a history of stroke, chronic kidney disease, and atrial fibrillation had an even higher risk of developing subdural hematoma, with those having atrial fibrillation facing the highest risk.
Dr. Wei advises individuals with these conditions to seek medical attention immediately if they experience weakness or abnormal movements in their limbs. After receiving treatment, family members must closely monitor the patients for two to three months, and if any unusual symptoms arise, they should schedule a follow-up visit.
