Falx interhemispheric subdural hematoma in a hypertensive patient with urticaria: A case report

Abstract

Falx interhemispheric subdural hematoma (FISH) is a rare subtype of subdural hematoma that occurs between the cerebral hemispheres along with falx cerebri. It represents less than 0.5% of all subdural hematomas and is frequently misdiagnosed due to its rarity and nonspecific clinical presentation. We present a case of 59-year-old female with a history of urticaria and hypertension who developed FISH following minor head trauma. The patient experienced presyncope, nausea, dizziness, and headache. A non-contrast computed tomography (CT) scan of the head revealed FISH, and the patient was managed conservatively without surgical intervention. This case report highlights the importance of considering FISH in the differential diagnosis of patients presenting with headache, dizziness, and presyncope, particularly in the setting of minor head trauma. We discuss the potential relationship between FISH, urticaria, and hypertension, as well as the possible causes of presyncope in this case, including orthostatic hypotension probably due to vagal nerve stimulation. Indeed, further studies are needed to explore these associations and to better understand the underlying mechanisms.

Keywords

• Emergency medicine
• FISH
• Headache
• Hypertension
• Minor head trauma
• Presyncope