[A case of bilateral interhemispheric subdural hematoma].

Area of Science:

• Neurosurgery
• Neuroradiology
• Traumatic Brain Injury

Background:

• Interhemispheric subdural hematoma (ISDH) is uncommon in adults, with bilateral presentations being exceedingly rare.
• Fewer than 40 adult cases of ISDH have been documented, and only 5 cases of bilateral ISDH.
• This report presents the sixth documented case of bilateral ISDH in an adult patient.

Observation:

• A 68-year-old woman presented with headache and vomiting after a fall with brief loss of consciousness.
• Neurological exam revealed hyperreflexia; CT scans showed high-density lesions along the falx and tentorium.
• Cerebral angiography indicated mass effect with displacement of the callosomarginal artery.

Findings:

• The patient developed progressive paraparesis and left arm paresis 14 days post-trauma.
• Surgical intervention via parasagittal craniotomy and hematoma evacuation was performed on day 19.
• Postoperative recovery was uneventful, with complete resolution of neurological deficits.

Implications:

• This case underscores the possibility of bilateral ISDH in adults, even with seemingly minor head trauma.
• Prompt diagnosis and surgical intervention are crucial for favorable outcomes in rare adult ISDH cases.
• Highlights the importance of advanced imaging and surgical management for complex intracranial hematomas.