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A case of delayed subdural hematoma

Y Koumtchev1, S Petkov, G Gozmanov

  • 1Department of Neurosurgery, University of Medicine, Plovdiv, Bulgaria.

Folia Medica
|January 1, 1994
PubMed
Summary

Delayed traumatic intracranial hematomas can occur, challenging the assumption of rapid hematoma expansion. This case highlights the importance of considering delayed diagnoses in traumatic brain injury patients.

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Area of Science:

  • Neuroscience
  • Trauma Surgery
  • Neuropathology

Background:

  • Current understanding suggests traumatic intracranial hematomas rapidly achieve maximum size post-injury.
  • However, literature includes cases of delayed traumatic intracranial hematomas following initially negative imaging.

Observation:

  • A 70-year-old male presented after a road accident with disorientation but normal neurological status.
  • Deterioration occurred on day two, leading to coma and left hemiparesis.
  • Emergency left carotid angiography was negative for hematoma.

Findings:

  • Postmortem examination revealed a significant left parietotemporal subdural hematoma (approx. 100 ml).
  • Associated findings included encephalomalacia and cerebral edema.

Implications:

  • This case underscores the possibility of delayed traumatic intracranial hematoma formation.
  • It emphasizes the need for vigilance and potential re-evaluation in patients with traumatic brain injury, even after initial negative imaging.
  • The findings challenge the established timeline for hematoma expansion after head trauma.

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