Acute subdural hemorrhage with subfalcine herniation

Case contributed by Dr Seamus O'Flaherty


Fall with headstrike. Reduced GCS. Recent craniotomy and excision of 4th ventricle epyndymoma.

Patient Data

Age: 70 years
Gender: Male

Large right frontal convexity subdural hematoma with significant mass effect resulting in 2cm left midline shift and subfalcine herniation. Posterior fossa structures normal.  No calvarial or skull base fracture. 

Case Discussion

This patient fell and hit his head whilst rehabilitating following a craniotomy for excision of a 4th ventricle epyndymoma. 

He had bilateral fixed dilated pupils and a GCS of 4, with loss of airway tone and reflexes. He was rapidly intubated and transferred to the operating theater for emergency craniotomy with evacuation of the subdural hematoma. 


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Case information

rID: 81758
Published: 4th Sep 2020
Last edited: 4th Sep 2020
Inclusion in quiz mode: Included
Institution: Epworth Healthcare

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