DIAGNOSES AND DISCUSSION OF CHALLENGING CLINICAL CASE NO. 10/2001
Subdural hematoma
| The cause of chronic subdural hematoma may be a trivial or unapparent injury, such as might be sustained by a sudden deceleration experienced in a motor vehicle accident. Symptoms are relatively nonspecific, usually characterized by aan intermittent headache accompanied by some degree of personality change, drowsiness, sor confusion. This condition is easily confused with drug intoxication, stroke, dementia, and depression. For the patient in the question, however, the lack of focal findings argues against stroke and the rapidity of onset would be unusual for dementia. The CT scan does not define the hematomas because they have become isodense with the passage of time (2 to 6 weeks since injury); however, the absence of sulci and the small size of the ventricles coupled with the clinical scenario are highly suggestive of bilateral subdural hematomas. Surgical evacuation of the hematomas is the treatment of choice. |