J Korean Soc Emerg Med.  2017 Jun;28(3):275-281. 10.0000/jksem.2017.28.3.275.

Lethal Outcome due to Misdiagnosis between Acute Cerebral Infarction and Epidural Hematoma Expansion after Blunt Trauma: A Case Report

• Yun JH

• KMID: 2386580
• DOI: http://doi.org/10.0000/jksem.2017.28.3.275

Abstract

Large amount of epidural hematoma usually requires surgical intervention. When the amount of epidural hematoma is increasing gradually, causing neurological symptoms, an early emergent surgery may be the only way to prevent lethal outcome. Among many factors associated with the prognosis, age, amount of hematoma, patient's consciousness at the time of admission, and other accompanying injuries are known to be important factors. However, in some cases, symptoms may be exacerbated due to causes other than the increase in epidural hematoma, such as cerebral infarction. In particular, calcification of the internal carotid artery is known to be an important factor that causes acute cerebral infarction before and after surgery. Correct identification is important for appropriate treatment between cerebral infarction and cerebral hemorrhage. Herein, we present a case that followed lethal outcome due to misdiagnosis between epidural hematoma expansion and acute cerebral infarction caused by dissection or calcification of the internal carotid artery after blunt trauma. To the best of our knowledge, there have been any reports regarding simultaneous occurrence of acute cerebral infarction and acute epidural hematoma on the same side following blunt trauma.

Keyword

Cranial epidural hematoma; Cerebral infarction; Carotid Artery; Internal; Vascular calcification

MeSH Terms

Carotid Arteries
Carotid Artery, Internal
Cerebral Hemorrhage
Cerebral Infarction*
Consciousness
Diagnostic Errors*
Hematoma*
Hematoma, Epidural, Cranial
Prognosis
Vascular Calcification