A combination of acute and delayed contralateral epidural hematoma
Introduction. An acute bilateral extradural hematoma is an uncommon presentation of traumatic head injury; however, it leads to higher mortality rate than acute unilateral hematoma. A delayed epidural hematoma (DEDH) is a hematoma that is not present on initial computed tomography (CT) scan...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Serbian Medical Society
2018-01-01
|
| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2018/0370-81791700134K.pdf |
| Summary: | Introduction. An acute bilateral extradural hematoma is an uncommon
presentation of traumatic head injury; however, it leads to higher mortality
rate than acute unilateral hematoma. A delayed epidural hematoma (DEDH) is a
hematoma that is not present on initial computed tomography (CT) scan but is
found on subsequent CT. While reviewing the literature, we could not find
recently published papers considering supratentorial DEDH after primary
operated contralateral EDH. Case report. A comatose 14-year-old male, with
Glasgow Coma Scale score 4 and the right midriatic pupil on the side of the
blunt trauma to the head, was admitted to ICU after he had survived a
traffic accident. Initial brain CT scan showed an acute temporoparietal
epidural hematoma on the right side of the cranium, with impressive midline
shift and bilateral linear skull fracture. Surgery was performed and
intracranial pressure (ICP) monitor was implanted, which showed the
increased values of ICP. A control brain CT scan performed within 24 hours
showed a new contralateral occipitoparietal epidural hematoma. Another
operation was performed. Second, control CT brain scan showed favorable
finding. The patient was transferred after 25 days to the rehabilitation
center, with the disability rating score of 11 and after 3 months it was1.
Conclusion. A contralateral DEDH is a lifethreatening neurosurgical
emergency case which can occur during the first 24 hours after decompressive
craniectomy. Control and ICP monitoring is recommended in these cases,
especially after surgical decompression. |
|---|---|
| ISSN: | 0370-8179 2406-0895 |