Resumen

Context: Chronic Subdural Hematomas are frequent diseases in Neurosurgery units. Decreased level of consciousness is observed in 28 to 100% of cases, nevertheless in rare cases are seen comatous patients. We describe a case of a patient with clinical uncal herniation elapsed by a chronic subdural hematoma. Case report: Patient with previous diagnosis of breast cancer, presented sudden occurrence of a headache followed by decreasing level of consiousness the day before reaching our service. The patient was taken than to another Hospital at 1:00 AM in Glasgow Coma Scale (GCS) 13, with isochoric pupils. At 7:00 AM the GCS went to 7 and the pupils became anisochoric L > R and than transferred to our Unit and immediately submitted to a computed tomography scanning of the head that showed a chronic subdural hematoma with midline shift. The patient promptly was taken to surgical room and treated with a single burr hole with drainage of hypertensive chronic subdural hematoma. The level of consiousness increased few hours after surgery, being in GCS 15 just 6 hours after, without motor deficits. Conclusion: In spite of commonly progressive evolution chronic subdural hematomas can present with herniation, becoming itself a neurosurgical emergency.

Palabras clave: Chronic subdural hematoma coma hemorrhages hypertensive intracranial surgery.

2007-10-31   |   3,771 visitas   |   Evalua este artículo 0 valoraciones

Vol. 30 Núm.2. Octubre 2007 Pags. Rev Chile Neuroc 2007; 30(2)