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Transient neurologic deficit caused by chronic subdural hematoma
H J Kaminski1, M L Hlavin, M J Likavec
1Department of Neurology, MetroHealth Medical Center, Cleveland, Ohio.
The American Journal of Medicine
|June 1, 1992
Summary
Transient neurologic deficits, like aphasia, can signal chronic subdural hematoma. Prompt neuroimaging is crucial for diagnosis and timely surgical drainage, which offers a curative outcome.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Chronic subdural hematoma (CSH) is typically associated with persistent neurological deficits.
- Unusual presentations of CSH, such as transient neurologic deficits, are less commonly recognized.
Observation:
- This study presents three cases of CSH presenting with transient aphasia and right-sided sensory-motor abnormalities.
- A literature review identified 32 similar cases, highlighting aphasia (77%) and sensory symptoms (57%) as common presenting complaints.
Findings:
- Cerebral angiography in 15 patients revealed significant carotid atherosclerosis in only three.
- Electroencephalograms in seven patients showed lateralized slowing in five, but no epileptiform activity.
- Surgical drainage of the subdural hematoma was curative in all cases, with only six patients experiencing transient postoperative symptoms.
Implications:
- Transient neurologic deficits warrant neuroimaging to exclude chronic subdural hematoma.
- Early diagnosis and surgical intervention for CSH presenting with transient symptoms lead to favorable outcomes.
- Recognizing atypical CSH presentations is vital for accurate and timely patient management.