Michael J Mulcahy1, Joga Chaganti2, Ashraf Dower3, Darweesh Al-Khawaja3. 1. Department of Neurosurgery, Nepean Public Hospital, Sydney, Australia. Electronic address: mmulcahy@mqneurosurgery.com. 2. Department of Radiology, Nepean Public Hospital, Sydney, Australia. 3. Department of Neurosurgery, Nepean Public Hospital, Sydney, Australia.
Abstract
BACKGROUND: Spontaneous acute arterial subdural hematoma (SDH) is a rare entity caused by hemorrhage from a cortical perisylvian artery without a known precipitant. CASE DESCRIPTION: A 53-year-old man presented with a 2-day history of acute-onset headache and dysphasia. He had a generalized seizure on arrival to hospital and no history of trauma. A computed tomography demonstrated an acute left-sided SDH. A computed tomography angiogram and a digital subtraction angiogram demonstrated active contrast extravasation into the SDH. A craniotomy was performed to evacuate the hematoma; the bleeding perisylvian artery was visualized and coagulated. CONCLUSIONS: We report a rare case of acute SDH and present a review of the literature. The etiology, investigation, and management of this rare neurosurgical emergency are discussed.
BACKGROUND: Spontaneous acute arterial subdural hematoma (SDH) is a rare entity caused by hemorrhage from a cortical perisylvian artery without a known precipitant. CASE DESCRIPTION: A 53-year-old man presented with a 2-day history of acute-onset headache and dysphasia. He had a generalized seizure on arrival to hospital and no history of trauma. A computed tomography demonstrated an acute left-sided SDH. A computed tomography angiogram and a digital subtraction angiogram demonstrated active contrast extravasation into the SDH. A craniotomy was performed to evacuate the hematoma; the bleeding perisylvian artery was visualized and coagulated. CONCLUSIONS: We report a rare case of acute SDH and present a review of the literature. The etiology, investigation, and management of this rare neurosurgical emergency are discussed.