Subdural Hemorrhage in a Military Aviator

The occurrence of any intracranial bleeding is highly significant from an aeromedical risk perspective and potentially career-ending for a military aviator. Where it arises from head trauma, there is always concern regarding ongoing risk of post-traumatic epilepsy.

A 26-yr-old male military aviator with persistent headache was found to have small right frontal and parietal subacute subdural hematomas, most likely precipitated by minor head trauma and possibly exacerbated by other concurrent physiological stressors. The hematomas resolved with conservative management and the aviator made a full recovery.

The association between traumatic subdural hematomas and the occurrence of post-traumatic epilepsy is well documented, and this, together with the possibility of recurrent bleeding, must be considered the significant aeromedical risks. However, this case presents an unusual situation of small subdural hematomas in isolation with no other features suggestive of significant traumatic brain injury. Relevant medical literature was found to be substantially lacking, and no other similar case reports of aviators could be found. An aeromedical decision-making process is discussed in relation to returning the aviator to flying duties in a restricted capacity.