[Chronic subdural hematoma with psychopathological manifestations]

A seventy-one-year old male patient was consulted by psychiatrist at the request of family physician on account of growing dementia. The first examination revealed deteriorated verbal contact, deficiency of memory and intellect and problems with sense of locality. Neither hallucinations nor delusions were found. However, after a detailed examination it was established that deterioration in verbal contact was due to aphasia and not dementia. Also, right side hemiparesis of small degree was detected. In spite of these symptoms the patient was able to move by himself. After admission to neurological department, computer tomography of brain was performed. It showed big subdural hematoma whose size was 13.2 by 2.9 cm. Adequate surgery was carried out and the patient was discharged from hospital ten days after operation. During supervisory examination, performed two months after intervention, no psychopathological problems were found. Also, deficiencies of memory, intellect and concentration were normal for the patient's age. The presented instance is a good argument for thorough examination of mental and neurological state, even in apparently evident cases. This description is illustrated with two tomograph pictures of brain.