Option for surgical management of cerebral haematoma: case report

A 48-year-old male patient, a surgeon, displayed a right temporo-occipital cerebral haematoma (5 x 7 cm). He had a history of chronic left occipital migraine-like cephalalgia from the age of 16 and hypertension was diagnosed when he was 42 years old. As therapy, he used ACE inhibitors, nifedipine and clonidine for hypertension and for cephalalgia a combination of aspirin, phenacetin and caffeine. During the last 2-3 months before the detection of cerebral haematoma, injections with piritramide were made when severe headaches were unbearable. The patient was operated on the 7th day since the onset of cerebral haematoma after a "wait and see" period of repeated clinical and CT-scan assessment. The initial option of the patient was surgical. We consider that the patient's profession (medical/surgical profile) may have played a positive motivation for the surgical option.