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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Delayed Acute Subdural Hematoma Associated With Percutaneous Coronary Intervention
Nobuhiko Arai1, Akiyoshi Nakamura, Masanao Tabuse
1Department of Neurosurgery, Hiratsuka City Hospital, Minamihara, Hiratsuka City, Kanagawa, Japan.
The Journal of Craniofacial Surgery
|August 16, 2016
Summary
Delayed acute subdural hematoma (DASH) can occur after percutaneous coronary intervention (PCI), even with a clear initial head CT. Prompt surgical intervention is crucial when consciousness declines following PCI to prevent fatal outcomes.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Delayed acute subdural hematoma (DASH) is defined as a subdural hematoma not visible on initial computed tomography (CT) after head trauma.
- DASH following mild traumatic brain injury (TBI) in conjunction with percutaneous coronary intervention (PCI) is rarely documented.
Observation:
- A 63-year-old female experienced cardiac arrest requiring PCI.
- Initial head CT post-trauma showed no intracranial hemorrhage.
- One hour after PCI, the patient lost consciousness, with subsequent CT revealing acute subdural and subarachnoid hemorrhage.
Findings:
- The patient deteriorated rapidly, progressing to brain herniation within 30 minutes of losing consciousness.
- Despite emergent surgical decompression, the patient demised 24 hours post-operation.
Implications:
- This case highlights a potential association between PCI and the development of DASH.
- Clinicians must maintain a high index of suspicion for delayed intracranial hemorrhage in patients undergoing PCI, especially after head trauma.
- Timely surgical intervention is critical for patients presenting with decreased consciousness post-PCI and initial negative head CT findings.
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