Recurrent Psychotic Depression Associated with Chronic Subdural Haematoma: A Case Report.

Area of Science:

• Neurology
• Psychiatry
• Neurosurgery

Background:

• Chronic subdural hematomas (CSDH) are uncommon, particularly when presenting solely with psychiatric disturbances.
• Repetitive head trauma can lead to CSDH, even in the absence of overt neurological deficits.

Observation:

• A 77-year-old female developed psychotic depression following repetitive head trauma, with no initial neurological signs.
• Brain MRI confirmed bilateral subdural hematomas: 20 mm on the right and 7 mm on the left.

Findings:

• Psychiatric symptoms significantly improved post-hematoma evacuation.
• A relapse of psychiatric symptoms occurred concurrently with the development of right-sided pneumocephalus.
• Resolution of pneumocephalus led to a sustained improvement in psychiatric symptoms.

Implications:

• Isolated psychiatric symptoms should prompt consideration of underlying subdural hematomas.
• Surgical intervention for CSDH plays a vital role in managing psychiatric manifestations.
• This case highlights the importance of neurosurgical evaluation in patients with unexplained psychiatric changes.