Delayed Sequential Multiple Extradural Hematomas – Case Report and Review of Literature

Abstract

Multiple extradural hematomas (EDH) >= 3 are an uncommon occurrence especially when they arise sequentially over a period of time. We present a case of delayed multiple EDH in a patient with trauma. A 31-year-old male presented to us with a moderate head injury (GCS-9). CT revealed diffuse axonal injury. He was electively ventilated and an intracranial pressure (ICP) monitor was placed. ICP increased over the next few hours. Repeat CT scan (8 hours after injury) revealed bilateral EDH (Right parietal and Left parieto occipital). He underwent emergency craniotomy and evacuation of both the EDH’s. Subsequently a repeat CT scan (6 hours later) revealed a right parieto occipital EDH for which he underwent craniotomy and evacuation. Subsequently the patient made an uneventful recovery. Careful monitoring and appropriate management gives excellent results. We also review the relevant literature.

Keywords

• Multiple sequential extradural hematoma