Abstract
Interhemispheric subdural hematomas are a relatively uncommon type of subdural hematoma. A surgical case of acute interhemispheric subdural hematoma following head trauma with a widespreaded convexity subdural hematoma was reported. The patient was a 75-year-old female, who was hit in her occipital region. At the time of admission, she was in a semicomatose state and this was noted as associated with anisocoria. CT scans showed a thick convexity subdural hematoma and an thin interhemispheric subdural hematoma on the left side. Immediately after admission, surgery was performed for the left convexity subdural hematoma. Postoperative CT scans demonstrated an unexpected increase of the left interhemispheric subdural hematoma. And also, her consciousness disturbances (JCS 30) and right hemiparesis remained left. We decided to perform surgery for the left interhemispheric subdural hematoma. Left small frontal craniotomy was performed. In the surgery, a micro laceration of the cortical artery was confirmed as the bleeding point. Her symptoms improved postoperatively. This is the first report representing the interesting mechanism of a micro laceration of the cortical artery. We concluded that surgical management should be considered to confirm the bleeding point in these cases where severe symptoms are continuously present.
