case_images: PMC6417290_01
case_images: Computed tomography scan image shows a subdural collection on the right side with a lesser subdural collection on the left side. A midline brain shift is present
case_images: AJNS-14-249-g001.jpg
case_images: PMC6417290_01_AJNS-14-249-g001.jpg
case_images: F1
case_images: In consideration of the persistence of headache in clinostatism, we decided to perform a brain computed tomography (CT) scan, which showed a bilateral subdural hematoma, larger on the right side (12 mm) causing a left-sided brain shift of about 5.3 mm [Figure 1].
case_images: Computed tomography scan image: the subdural collection is increased in dimension with a higher density in the posterior part by persistent midline brain shift
case_images: AJNS-14-249-g002.jpg
case_images: PMC6417290_01_AJNS-14-249-g002.jpg
case_images: F2
case_images: CT scan which showed an increase in density of the subdural collection with an increase in brain shift [Figure 2]. Considering that the conservative treatment was not sufficient, we considered and proposed a subdural hematoma evacuation, which the patient accepted.
case_images: Postsurgical computed tomography scan control shows the evacuation of the collection with air in the anterior part and a reduction of midline brain shift
case_images: AJNS-14-249-g003.jpg
case_images: PMC6417290_01_AJNS-14-249-g003.jpg
case_images: F3
case_images: The postoperative CT scan showed the evacuation of the blood collection with reduction of the midline brain shift [Figure 3].
case_images: (a) shows the subdural collection with air inclusions (b) shows the important brain shift due to the collection (c) shows an increase in the subdural collection
case_images: AJNS-14-249-g004.jpg
case_images: PMC6417290_01_AJNS-14-249-g004.jpg
case_images: F4
case_images: A brain CT scan was performed demonstrating a reformation of the subdural hematoma on the right side larger than that one before surgery; hydration, analgesia, and bed rest were again implemented [Figure 4a and b]. Nine days after the intervention, a cranial CT showed a further increase of the subdural blood collection with brain shift [Figure 4c].
case_images: Control computed tomography scan shows no more subdural collection with no midline brain shift
case_images: AJNS-14-249-g005.jpg
case_images: PMC6417290_01_AJNS-14-249-g005.jpg
case_images: F5
case_images: Three months after surgical procedure, the patient was symptom free, and CT scan showed a complete resolution of the subdural hematoma without brain shift [Figure 5].