PMC9479523_01
Coronal image of computed tomography (CT) on admission. CT shows acute interhemispheric subdural hematoma (AISDH) of 2.5 cm in the maximum thickness and thin bilateral convexity subdural hematoma.
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F1
Computed tomography (CT) of the head showed AISDH of 2.5 cm in thickness and thin bilateral convexity subdural hematomas [Figure 1].
Intraoperative findings during removal of AISDH. Intraoperative findings show that there is neither brain contusion nor a rupture of the bridging vein (a). *Brain. As the hematoma is removed, arterial bleeding (arrow) is found from a branch of anterior cerebral artery (ACA) (b). The vessel is torn and the other end is found to be continuous with the cerebral falx from which arterial bleeding (arrowhead) is also observed (c). Both ends of the vessel are very close together and are coagulated to stop bleeding (torn ends of the ACA branch: arrow, brain side; arrowhead, falx side) (d).
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F2
Intraoperatively, there was neither brain contusion nor a rupture of the bridging vein found [Figure 2a]. As the hematoma was removed, arterial bleeding was seen arising from a branch of ACA [Figure 2b]. The vessel was torn and the other end was found to be continuous with the cerebral falx, from which arterial bleeding was also observed [Figure 2c]. Both ends of the vessel were very close together and coagulated to stop bleeding [Figure 2d]: thus, it was determined that the damage to the dural branch from ACA to the cerebral falx was the cause of the hemorrhage.
Coronal image of postoperative CT. AISDH is near totally removed.
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Postoperative CT demonstrated that the AISDH was near totally removed [Figure 3].