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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Contrecoup Extradural Hematoma: When Hematomas Do Not Follow Rules.

Prashant Punia1, Ashish Chugh1, Sarang Gotecha1

  • 1Department of Neurosurgery, Dr. D.Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, Maharashtra, India.

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|April 18, 2022
PubMed
Summary

Extradural hematoma (EDH) crossing a cranial suture at the contrecoup site is rare. This case highlights a unique presentation with sutural diastases, emphasizing the need for high suspicion and prompt diagnosis in neurosurgical practice.

Keywords:
Extradural hematomaextradural hematomahematoma across suturessuture diastases

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Area of Science:

  • Neurosurgery
  • Traumatic Brain Injury
  • Neuroradiology

Background:

  • Extradural hematoma (EDH) is common in neurosurgery.
  • EDH at a contrecoup site crossing a cranial suture is exceptionally rare.

Observation:

  • A case of EDH at the contrecoup site crossing the coronal suture with associated sutural diastases.
  • The patient also presented with a subdural hematoma (SDH) at the coup site.
  • This represents the 13th reported adult case of this rare condition.

Findings:

  • Computed tomography (CT) revealed a large EDH at the contrecoup site crossing the coronal suture and a smaller SDH at the coup site.
  • Intraoperative findings confirmed sutural diastases of the coronal suture.
  • Approximately 80cc of clot was evacuated, and hemostasis was achieved.

Implications:

  • Contrecoup EDH with sutural diastases challenges conventional understanding of hematoma formation.
  • A high index of suspicion and rapid diagnosis are crucial for favorable outcomes.
  • CT scans in all three planes with 3D reconstruction are recommended for diagnosis.