Y Koumtchev1, S Petkov, G Gozmanov
1Department of Neurosurgery, University of Medicine, Plovdiv, Bulgaria.
This case report describes a rare condition called interhemispheric subdural hematoma in a 65-year-old patient. The patient was hit on the head with a water pipe and initially had only a mild headache. Over the next 24 hours, his condition worsened, and he became comatose. Neurological examination revealed severe symptoms, including paraplegia and abnormal reflexes. A CT scan showed a high-density area in the brain, and surgery revealed a rupture in the sagittal sinus. Despite treatment, the patient died. The case is notable for the delayed onset of symptoms and the rare anatomical findings. The authors suggest that this case may help improve recognition and management of similar trauma cases.
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Area of Science:
Background:
Intracranial hemorrhage remains a critical concern in trauma care. Prior research has shown that subdural hematomas often result from blunt head trauma. However, interhemispheric subdural hematomas are uncommon. This gap motivated further investigation into their clinical presentation and outcomes. No prior work had resolved the full spectrum of symptoms associated with this condition. The rarity of this condition limits available data. This paper's contribution lies in documenting a unique case with specific anatomical findings. The case highlights the diagnostic challenges in trauma patients with delayed symptom onset. Understanding such rare presentations improves clinical recognition and management strategies.
Purpose Of The Study:
This case report aimed to document a rare presentation of interhemispheric subdural hematoma. The specific problem addressed was the delayed clinical manifestation despite initial trauma. The motivation stemmed from the need to expand knowledge on this uncommon condition. The authors sought to clarify the diagnostic and surgical implications. The patient's history and symptoms were analyzed to identify key features. The study focused on the neurological and imaging findings. The goal was to highlight the importance of early detection in trauma cases. The findings may help inform future trauma protocols and diagnostic approaches.
An interhemispheric subdural hematoma is a rare condition where blood accumulates between the brain's hemispheres. It is distinct from more common subdural hematomas.
The patient showed signs of meningoradicular irritation, bilateral Babinski reflex, and paraplegia. These symptoms indicated severe neurological involvement.
The rupture of the sagittal sinus is a rare and critical finding in subdural hematomas. It may contribute to rapid neurological deterioration.
The CT scan identified a high-density area in the interhemispheric sulcus. This finding guided the decision for emergency surgery.
Main Methods:
The study involved a single patient with a documented head injury. Clinical evaluation included neurological examination and CT imaging. The patient's symptoms were recorded over a 24-hour period. The neurosurgeon performed a physical and neurological assessment. An emergency CT scan was used to identify intracranial abnormalities. Surgical intervention was conducted to address the hematoma. Post-operative outcomes were monitored until the patient's death. The case was analyzed for unique features such as sagittal sinus rupture.
Main Results:
The CT scan revealed a high-density area in the interhemispheric sulcus. The patient exhibited a lucid interval before symptom progression. Neurological findings included bilateral Babinski reflex and meningoradicular signs. The patient had paraplegia and paresis at the time of examination. The sagittal sinus rupture was identified during surgery. The patient's condition deteriorated rapidly post-operatively. The case demonstrated the potential severity of interhemispheric hematomas. The findings suggest a need for heightened awareness in trauma diagnostics.
Conclusions:
The authors propose that interhemispheric subdural hematomas may present with delayed symptoms. The case suggests that lucid intervals can occur despite significant trauma. The findings may help improve recognition of this rare condition. The authors emphasize the importance of imaging in trauma patients. The case highlights the diagnostic and surgical challenges involved. The authors suggest that further research is needed on similar cases. The study contributes to the understanding of trauma-related neurological outcomes. The authors do not claim this is the definitive cause of all interhemispheric hematomas.
Failed At:
2026-07-14T07:53:27.774716+00:00
The patient's condition worsened after surgery, and he ultimately died. This outcome underscores the severity of this condition.
The authors suggest that delayed neurological symptoms may indicate interhemispheric hematomas. Early imaging is recommended in such cases.