Bilateral asynchronous acute epidural hematoma : a case report

Eftekhar, Behzad; Ketabchi, Ebrahim; Ghodsi, Mohammad; Esmaeeli, Babak

doi:10.1186/1471-227x-3-1

Cited by 9 publications

(3 citation statements)

References 25 publications

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“…Teniendo en cuenta lo anterior y con base en la bibliografía proponemos el siguiente modelo (Tabla 1): Según su tiempo de aparición; sincrónicos cuando en la primera TAC se evidencian los dos hematomas, asincrónicos cuando se evidencia primero un hematoma y posteriormente en una TAC control se evidencia un hematoma distinto. 7 Según su posición a partir de la línea media; simétricos cuando por ejemplo los dos hematomas aparecen en las regiones temporales, asimétricos cuando por ejemplo aparece un hematoma temporal izquierdo y un hematoma occipital derecho. 8 Finalmente, según su localización craneocaudal; supratentoriales e infratentoriales, siendo estos últimos el 1.2% al 11% de todos los hematomas epidurales.…”

Section: Discussionunclassified

Bilateral Epidural Hematoma: Case Illustration and Classification Proposal

Muñoz¹,

Morán²,

Toro³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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El hematoma epidural es una complicación frecuente del trauma craneoencefálico cerrado, sin embargo, es infrecuente la presentación de manera bilateral y se asocia a elevada morbimortalidad. Presentamos un caso de paciente masculino de 28 años victima de accidente de transito quien presenta hematoma epidural inicialmente unilateral, y que después de 4 días se convierte en un hematoma epidural bilateral. Source of support: Nil Conflict of interest: None ABSTRACTEpidural hematoma is a frequent complication of closed craneoencephalic trauma, however, bilateral presentation is nonfrequent and it is associated with high morbimortality. We report a case of a male patient who suffered a road traffic accident and has unilateral epidural hematoma, which, after 4 days, becomes bilateral epidural hematoma.

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Section: Discussionunclassified

Bilateral Epidural Hematoma: Case Illustration and Classification Proposal

Muñoz¹,

Morán²,

Toro³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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“…If the patient does not improve after the hematoma removal or if there is any neurological deficits, further brain imaging is indicated in order to evaluate the efficacy of the drainage and the possible hematoma expansion. [ 7 9 17 ]…”

Section: Discussionmentioning

confidence: 99%

Bilateral assymetric epidural hematoma

et al. 2015

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Background:Acute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5–10% of all extradural hematomas. However, higher mortality rates have been reported in previous series.Case Description:The authors described the case of a 28-year-old male presenting head injury, comatose, Glasgow Coma Scale of 6, anisocoric pupils without puppilary light reflex. Computed tomography showed asymmetric bilateral epidural hematomas, effacement of the lateral ventricles and sulci, midline shift and a bilateral skull fracture reaching the vertex. Surgical evacuation was performed with simultaneous hematoma drainage. Patient was discharged on the 29th postoperative day with no neurological deficit.Conclusion:The correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage.

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“…It is usually unilateral, in only 2%-10% of cases it is bilateral [3]. Delayed EDHs are even rarer, and only a few reports can be found in literature [4,5]. Only one case of triple post-traumatic EDH had been reported [6].…”

Section: Introductionmentioning

confidence: 99%

Delayed Bilateral, Post-Traumatic Extra-Subdural Hematomas in a Patient with Meningioma

Umana¹,

Ferini²,

Crea³

et al. 2022

Oncologie

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Concomitant acute epidural hematoma (EDH) and subdural hematoma (SDH) is a rare finding, and its bilateral onset has not yet been reported in literature. We present the first report of a patient affected by post-traumatic concomitant EDH and SDH, with the contralateral, delayed onset of another, associated with meningioma previously treated with gamma knife. A 60-year-old female patient with a history of simple focal seizures with motor symptoms and well-controlled by drugs since childhood, arterial hypertension, and incidental diagnosis of multiple meningiomas was referred to our department after falling down the stairs. Initially, the patient was prescribed gamma knife treatment of the right frontal convexity meningioma. The patient was admitted to our emergency department with Glasgow Coma Scale (GCS) score of 7/15 and isochoric, myotic pupils. An immediate head CT scan revealed a small acute SDH in the right hemisphere and an acute blood collection in the left hemisphere, which exerted mass effect; furthermore, we discovered complex skull fractures across the superior sagittal sinus, and dislocated bone fragments. A left decompressive craniectomy was performed, and intraoperatively we observed a concomitant EDH/SDH. Due to the patient's anisocoria, an urgent postoperative CT scan was performed, revealing a massive blood collection in the right hemisphere, which was discovered to be another concomitant EDH/SDH, during right trauma flap. Through this approach, we also removed the right frontal convexity meningioma. After 5 days in the intensive care unit (ICU), the patient died because she presented an acute heart failure. The development of a contralateral, delayed EDH/SDH must be considered in severe traumatic patients, especially if associated fractures across major dural sinuses are present. Intraoperative CT scan, if available, or immediate postoperative CT scan, is mandatory for adequate management of complex neurotrauma cases.

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Bilateral asynchronous acute epidural hematoma : a case report

Cited by 9 publications

References 25 publications

Bilateral Epidural Hematoma: Case Illustration and Classification Proposal

Bilateral Epidural Hematoma: Case Illustration and Classification Proposal

Bilateral assymetric epidural hematoma

Delayed Bilateral, Post-Traumatic Extra-Subdural Hematomas in a Patient with Meningioma

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