Subacute Subdural Hematoma Presenting as Non-Fluent Aphasia

Abstract

We present the case of a 69-year-old male, alcohol consumer, who was brought in by the ambulance for language impairment with onset two days prior to presentation in our hospital. Medical history revealed therapeutically neglected gout and colchicine allergy. On neurological exam, the patient presented predominantly motor aphasia with poor verbal fluency and anomic elements, mild right-sided hemiparesis 4/5 MRC and right-sided Babinski sign. Still, he was conscious and cooperative, and denied any recent head trauma or headache. Based on clinical picture, an acute cerebrovascular event was suspected, and the patient was hospitalized. However, brain CT revealed a late subacute subdural hematoma in the left hemisphere, with maximum thickness of 20 mm and displacement of median structures by 12 mm to the right (subfalcine herniation). The patient was then rapidly transferred to a Neurosurgical department for appropriate treatment and care.