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Acute-on-chronic subdural hematoma
© The Author(s) 2010
- Received: 19 April 2010
- Accepted: 18 August 2010
- Published: 2 November 2010
- Physical Exam
- Subdural Hematoma
- Breakdown Product
- Common Sign
A 38-year-old male complains of a right-sided retro-orbital-temporal headache of 2-day duration. It is described as intermittent and pressure-like, and is preceded by bouts of left arm numbness. He denies diplopia, visual changes, nausea, vomiting, or alterations in his consciousness. No acute trauma is reported, but he gives a history of airline travel within the past 24 h. His parents are present at the bedside and volunteer that the patient and his wife were involved in a motorcycle crash 3 months ago in which his wife was killed.
The patient is alert and oriented with normal vital signs and a normal physical exam. A CT of the head without contrast is performed and reveals an acute-on-chronic subdural hematoma with a 1.6-cm midline shift (Figs 1, 2 and 3). Neurosurgery is performed emergently.
- Meagher, R. Subdural Hematoma. The EMedicine Clinical Knowledge Database [online] Nov 2, 2006 available at: http://www.emedicine.com/neuro/TOPIC575.HTM
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