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Published on: July 21, 2013
Posterior fossa subdural hematoma resulting in locked-in syndrome: case report
Cara L Sedney1, Brenton R Coger, Julian E Bailes
1Department of Neurosurgery, West Virginia University, Morgantown, West Virginia 26506, USA. csedney@hsc.wvu.edu
Background And Importance:
Locked-in syndrome (LIS) is a well-known and devastating clinical entity, of which stroke is the most common cause; the distant second, trauma, usually results in LIS from basilar artery dissection. Our case report describes a posterior fossa subdural hematoma causing LIS, likely by direct compression of neural structures, which is a unique etiology and prognosis compared with other causes.
Clinical Presentation:
A 34-year-old female experienced a posterior fossa subdural hematoma. She was taken emergently for evacuation, and on postoperative examination was found to be locked-in. The symptom complex, while classic for LIS, resolved at an accelerated rate compared with previous reports. Emergent evacuation of clot and rehabilitation were performed.
Conclusion:
Prompt treatment allowed this patient to experience an accelerated and more complete recovery compared with the ischemic causes of LIS.
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