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Bilateral asynchronous acute epidural hematoma : a case report

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Author(s): Eftekhar Behzad | Ketabchi Ebrahim | Ghodsi Mohammad | Esmaeeli Babak

Journal: BMC Emergency Medicine
ISSN 1471-227X

Volume: 3;
Issue: 1;
Start page: 1;
Date: 2003;
Original page

Keywords: bialteral | epidual | hematoma

ABSTRACT
Abstract Background Bilateral extradural hematomas have only rarely been reported in the literature. Even rarer are cases where the hematomas develop sequentially, one after removal of the other. Among 187 cases of operated epidural hematomas during past 4 years in our hospital, we found one case of sequentially developed bilateral epidural hematoma. Case Presentation An 18-year-old conscious male worker was admitted to our hospital after a fall. After deterioration of his consciousness, an emergency brain CT scan showed a right temporoparietal epidural hematoma. The hematoma was evacuated, but the patient did not improve afterwards. Another CT scan showed contralateral epidural hematoma and the patient was reoperated. Postoperatively, the patient recovered completely. Conclusions This case underlines the need for monitoring after an operation for an epidural hematoma and the need for repeat brain CT scans if the patient does not recover quickly after removal of the hematoma, especially if the first CT scan has been done less than 6 hours after the trauma. Intraoperative brain swelling can be considered as a clue for the development of contralateral hematoma.
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