Rapid Disappearance of Acute Unilateral Epidural Hematoma Due to Compression of Contralateral Subdural Hematoma

A 54-year-old man presented with unconsciousness for 2 hours after head trauma. Brain CT revealed vanished epidural hematoma and expanded subdural hematoma compared with brain CT performed 1 hour before (Figure). An operation plan to evacuate the left subdural hematoma and then the right subgaleal hematoma was made.1 However, respiratory and cardiac arrest occurred, accompanied by lasting hypotension, and blood test revealed acute disorders of coagulation and decreased platelets contraindicating surgery. He received conservative treatment and died 36 hours after trauma. Although rare, acute epidural hematoma total shifts into subgaleal hematoma could occur because of rapidly increased intracranial pressure in patients with coagulation disturbance.

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