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Fatal Brain Herniation in Bilateral Chronic Subdural Hematoma
Yo Han Ahn1, JongKyu Kim1, Seok Won Kim1
1Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
Korean Journal of Neurotrauma
|November 16, 2022
Summary
Delayed surgical intervention for bilateral chronic subdural hematoma (SDH) can be fatal. This case highlights the critical need for prompt surgical treatment to prevent severe brain complications and death.
Area of Science:
- Neurosurgery
- Neurology
- Geriatric Medicine
Background:
- Chronic subdural hematoma (SDH) is a common neurosurgical condition, often associated with mild head trauma or occurring spontaneously in elderly individuals.
- While typically benign, delayed diagnosis and treatment of SDH can lead to significant morbidity and mortality.
Observation:
- An 84-year-old male presented with bilateral chronic subdural hematoma.
- The patient experienced a fatal outcome due to brainstem herniation (duret hemorrhage) and ischemic injury in the occipital and temporal lobes.
Findings:
- The case demonstrates a catastrophic progression of untreated bilateral chronic SDH.
- Autopsy revealed duret hemorrhage and cerebral ischemia, indicating severe secondary brain injury.
Implications:
- This case underscores the critical importance of timely surgical evacuation for bilateral chronic subdural hematoma, even in the elderly.
- Urgent surgical intervention is paramount to prevent irreversible neurological damage and mortality associated with SDH.
- A review of literature reinforces the necessity of prompt management strategies for chronic subdural hematoma.
