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Pyung Goo Cho, MD, Kum Whang, MD, Jhin Soo Pyen, MD, Chul Hu, MD, Soon Ki Hong, MD, Hyun Ho Jung, MD
Abstract
Interhemispheric subdural hematoma (ISH) had been considered very rare until identification with image studies, such as brain computed tomography (BCT) and magnetic resonance imaging (MRI). There are still some controversies in the management ISH, will be treated surgically or medically. We present one case of traumatic ISH which showed the falx syndrome after decompressive craniectomy for convexity subdural hematoma and was treated surgically with good outcome. Surgical treatment should be considered for symptomatic ISH patient, because ISH did not migrate over the convexity, as showed in our case.
Figures and Tables
FIGURE 1
A 56-year-old male patient was admitted to our hospital due to metal deterioration. Brain CT revealed the acute subdural hematoma on left frontotemporoparietal, so he was operated the decompressive craniectomy. A: Initial brain computed tomography showed acute subdural hematoma in interhemisphere and left frontotemporoparietal area. B: Interhemispheric subdural on hematoma was still remained postoperative computed tomography after decompression subdural hematoma on left convexity.
FIGURE 2
After decompressive craniectomy, falx syndrome was revealed due to interhemispheric subdural hematoma. A: At the time of falx syndrome, 22nd postoperative day, computed tomography was followed up and it showed increased size of interhemispheric subdural hematoma which was transformed to chronic form. B: After 3 days of drainage, the size of interhemispheric subdural hematoma was decreased. C: Interhemispheric subdural hematoma was absorbed totally on postoperative 3 weeks image study.
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