Acute on Chronic Bilateral Subdural Hematoma in a Woman with a Remote History of Previous Subdural Hematoma Managed by Trephination: A Case Report

Journal of Nepal Medical Association

article

Mitesh Karn¹  Sapana Yonghang¹ 

[1] Gandaki Medical College Teaching Hospital and Research Center

关键词: hematoma;    subdural;    trephination.;   

DOI  :  10.31729/jnma.5122

学科分类：社会科学、人文和艺术（综合）

来源: Nepal Medical Association since

【 摘 要 】

Bilateral chronic subdural hematoma are not that common. It may be recurrent and rarely superimposed by acute bleed leading to rapid progression and poor clinical outcomes. We report the case of a seventy six years old lady with a history of traumatic subdural hematoma evacuated by trephination twenty years back, presenting at our hospital with a history of persistent headache and acute onset of several episodes of vomiting. A non-contrast head CT revealed bilateral chronic subdural hematoma with acute on chronic bleed on one side. Trephination was done initially unilaterally, but the symptoms persisted and bilateral trephination was performed. The patient developed bilateral pneumocephalus and chest infection post-surgery. Bilateral, recurrent subdural hematoma with acute superimposition of bleed is a rare entity that presents with signs of increased intracranial pressure as opposed to unilateral SDH. A single burr hole trephination can be an effective intervention in these cases.

【 授权许可】

CC BY