PMC7568103_01
CT scans showing the patient's evolution. (a) Initial CT scan showing bilateral subdural hematomas. *(b) Postoperative CT scan showing bilateral mini-craniotomy with associated pneumoencephalus. (c) Acute left subdural hematoma after the right drain removal. (d) Postoperative CT scan taken after the first recurrence and second surgery, showing the left subdural hematoma that appeared 3 weeks after the second drain removal. (e) Final CT scan, the patient had no further subdural hematoma recurrences.
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F1
A noncontrast head CT scan was ordered, showing bilateral subacute SDH [Figure 1a]. The patient's evolution was uneventful with a normal postoperative physical examination and control CT scan [Figure 1b]. A new CT scan showed recurrence of the SDH on the left cerebral hemisphere, contralateral to the drain that was removed [Figure 1c]. A new CT scan showed recurrence of the left SDH and a new intervention for hematoma drainage with drain placement was scheduled [Figure 1d]. The patient was discharged with a normal CT scan [Figure 1e].
Preoperative and postoperative MRI scans. (a) Gadolinium-enhanced coronal head MRI showing a left subdural hematoma and diffuse pachymeningeal enhancement, taken after the first surgery and drain removal. (b) Control MRI taken 5 months after the third surgery, there is no recurrence of subdural hematoma or signs of intracranial hypotension.
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F2
For follow-up, the patient had an MRI scan after 5 months, with no findings related to intracranial hypotension or SDH [Figure 2] and there was no recurrence of neurologic signs after 24 months.