[Acute subdural hematoma following minor head injury]

A 73-year-old patient is described who developed tentorial herniation after a minor head trauma. The initial neurological examination was normal and she had no skull fracture. The cause turned out to be a subdural haematoma of arterial origin, without cerebral contusion or oedema. Prompt surgical intervention resulted in a excellent outcome. The authors conclude that a special form of acute subdural haematoma should be distinguished, which after minor head injury and a lucid interval results in sudden neurological deterioration, especially in the elderly. It has to be treated by prompt surgical intervention.