Publication: Acute on Chronic Bilateral Subdural Hematoma in a Woman with a Remote History of Previous Subdural Hematoma Managed by Trephination: A Case Report
Date
2020
Authors
Article Type
Case Report
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Volume Title
Pages
Pages: 607 - 610
Publisher
Nepal Medical Association
Abstract
Abstract
Bilateral chronic subdural hematoma are not that common. It may be recurrent and rarely superimposed by acute bleed leading to rapid progression and poor clinical outcomes. We report the case of a seventy six years old lady with a history of traumatic subdural hematoma evacuated by trephination twenty years back, presenting at our hospital with a history of persistent headache and acute onset of several episodes of vomiting. A non-contrast head CT revealed bilateral chronic subdural hematoma with acute on chronic bleed on one side. Trephination was done initially unilaterally, but the symptoms persisted and bilateral trephination was performed. The patient developed bilateral pneumocephalus and chest infection post-surgery. Bilateral, recurrent subdural hematoma with acute superimposition of bleed is a rare entity that presents with signs of increased intracranial pressure as opposed to unilateral SDH. A single burr hole trephination can be an effective intervention in these cases.
Keywords: hematoma; subdural; trephination.
Description
Mitesh Karn
Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal
Sapana Yonghang
Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal
Keywords
hematoma, subdural, trephination
Identifier
https://doi.org/10.31729/jnma.5122