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We report a case of a Syrian refugee patient with head trauma after falling backward from a chair accidentally, presented in emergency unit with loss of consciousness. He was found to have subdural hematomas (SDHs) on the right frontoparietotemporal region of the brain. He underwent operation for the evacuation of the SDH and early post-operative computed tomography (CT) showed 15 mm contralateral epidural hematoma (EDH) in the left occipital region and the posterior fossa regions which was not clearly detected in pre-operative cranial CT. The EDH thought to be due to dural sinus bleeding that unexpectedly crop up after the evacuation of the SDH and subsequently decrease in intracranial pressure and ease the tamponade pressure effect of SDH on contralateral left occipital might prepare the ground for EDH. The second operation is immediately done that the EDH was evacuated. In this case, we discussed the possibility of developing a combined EDHs on the opposite side of the evacuated hematoma, detection of SDH preoperatively which is unusual phenomenon in relation to EDHs which usually caused by tears in arteries, and it progresses dramatically very fast with first traumatic impact. Also to draw attention to skull trauma especially in the occipital region, because unexpected late epidural hematoma can be detected surprisingly at this region, as result of hemorage due to fractured skull bone and dural sinuses lacerations.

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