Interhemispheric Chronic Subdural Hematoma —Case Report

A 74-year-old male presented with right hemiparesis greater in the lower than the upper extremity. He had no apparent head trauma. He had been treated with anticoagulants for cerebral and myocardiac infarction. Computed tomography (CT) and magnetic resonance imaging demonstrated an unusual combination of subdural hematomas in the interhemispheric space on the left, and the left temporoparietal and right frontotemporooccipital regions. The left convexity hematoma was irrigated through a single burr hole. Postoperatively, the size of the left convexity hematoma was diminished and the left interhemispheric subdural hematoma disappeared. However, his consciousness deteriorated, and a second irrigation of the recurrent left convexity hematoma was performed 7 days after the first surgery. CT obtained 3 days after the second operation showed a right interhemispheric subdural hematoma, which diminished spontaneously. The convexity hematoma on the left reaccumulated, and was treated by shunting. His neurological status did not improve, and he died from myocardial infarction 39 days later. Irrigation of convexity hematoma may be effective to treat an associated ipsilateral interhemispheric subdural hematoma.