J Korean Neurotraumatol Soc.  2010 Dec;6(2):158-161. 10.13004/jknts.2010.6.2.158.

Interhemispheric Subdural Hematoma Presenting with Falx Syndrome after Trauma

• Lee M
• Kim MS
• Yoon SW

• KMID: 2106804
• DOI: http://doi.org/10.13004/jknts.2010.6.2.158

Abstract

Interhemispheric subdural hematoma (ISH) presenting with falx syndrome is a rare occurrence. We present a case of ISH presenting with falx syndrome with visual disturbances. A 66-year-old woman reported headache as a result of a fall. Initial nonenhanced computed tomography (CT) showed a left frontal ISH. Two days later, she was noted to have right homonymous hemianopsia and marked right hemiparesis, especially in the right lower extremity. Follow up CT demonstrated an increase in the size of the frontal ISH and a newly developed occipital ISH. On thirteen day after the trauma, she was treated with mannitol and dexamethasone. Twelve hours after the start of the mannitol and dexamethasone therapy, the patient showed marked improvement of the neurologic deficit. Five months after the trauma, she showed no neurological deficits.

Keyword

Hematoma; Subdural; Interhemispheric; Falx

MeSH Terms

Dexamethasone
Female
Follow-Up Studies
Headache
Hematoma
Hematoma, Subdural
Hemianopsia
Humans
Lower Extremity
Mannitol
Neurologic Manifestations
Paresis
Dexamethasone
Mannitol

Figure

• 

  FIGURE 1 Initial computed tomography scans demonstrated a small hematoma in the frontal interhemispheric space (A) and no hemorrhage in the occipital interhemisp-heric space (B).

• 

  FIGURE 2 Computed tomography scans obtained two days later. A: Frontal image showed enlargement of the frontal interhemispheric subdural hematoma (IHS). B: Occipital image showed extension of the hematoma to the left occipital interhemispheric space.

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  FIGURE 3 Diffusion-weighted magnetic resonance images obtained 13 days after the trauma. A: Frontal interhemispheric subdural hematoma (ISH) demonstrated no change of hemorrhage size. B: Occipital ISH also showed no change of hematoma. Both image showed no infarction.

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  FIGURE 4 Computed tomography scans obtained 20 days after the trauma. A: Frontal interhemispheic subdural hemtoma (IHS) demonstrated a partially resolving hemorrhage. B: Occipital ISH also showed partially resolved hematoma.

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