EC Neurology

Chronic subdural hematoma (CSDH) is an accumulation of aged blood between the dura mater and the arachnoid. It is a liquefied and encapsulated effusion located in the subdural space. The majority of chronic SDH cases arise as a de novo disease following minor head trauma without a prior acute stage of SDH. Additionally, many patients with chronic SDH do not have a clear history of trauma. We report the case of a 66-year-old patient who was assaulted three months ago and sustained a deliberate head injury (a blow to the head from a metal object). Four days before presentation, the patient developed left-sided weakness, prompting a consultation with a cardiologist, where a brain CT scan was performed. The scan revealed a frontoparietal septate chronic SDH on the right side. The patient underwent surgery with evacuation of the hematoma through two trephine holes, one frontal and one parietal, on the right side. The surgical outcome was favorable. The overall incidence of SCDH is reported to be approximately 10 per 100,000 people in the general population and may be as high as 100 per 100,000 among the elderly. Clinical signs vary and may include headache, mental status changes, weakness, seizures, gait disturbances, nausea, vomiting, and even disturbances of consciousness or coma. Chronic subdural hematoma is a common neurosurgical condition, especially in older male patients, and treatment is often surgical.

Keywords: Chronic Subdural Hematoma; Neomembrane; Burr Hole

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