A case of delayed subdural hematoma.

Over the recent years, a number of authors have assumed that traumatic intracranial hematomas reach their maximum size within minutes after the trauma. However, there are reports in the literature of proven traumatic intracranial hematoma of delayed onset after a negative computer tomographic or arteriographic study of the brain. We present a case of a 70-year-old patient admitted to the Clinic after a road accident. On admission the patient was disoriented in regard to time but his neurological status was otherwise normal. On the second day after admission the patient's condition deteriorated and he became comatose with moderate left hemiparesis. An emergency left carotid angiography was performed which was negative for a hematoma. Three days later the patient died. Postmortem examination disclosed a subdural hematoma in the left parietotemporal region with a volume of about 100 ml, as well as encephalomalacia and brain edema.