Traumatic Subacute on Chronic Subdural Hematoma: An Autopsy-based Case Report

Abstract

A typical consequence of head trauma and a notable finding during such autopsies  is subdural hematoma (SDH). Upon diagnosis, a variety of clinical manifestations,  including the lethal acute SDH, subacute, or chronic SDH (CSDH), may be present.  Sometimes, these traumas may be so trivial that the exact history of incidence may  be difficult to elicit, especially in the cases of subacute and chronic SDH. The signs  of subacute SDH are usually evident only after three days to 2 to 3 weeks and grossly  appear during autopsy as dark red-black liquefied blood with blood clots. CSDH is  a gelatinous membrane with outer and inner layers adherent to dura matter. The  present case is of a 47-year-old man with histories of falls, at his residence, first two  years no history of treatment was there and a recent fall, about two weeks and led to  the initial presentation of hemiparesis and hospitalization with a diagnosis of SDH,  the patient died after a week. This article discusses the findings observed in the case  where the cause of death was due to the complication of SDH, which was found  to be subacute on the chronic type. Such cases usually present late to the hospital  due to delayed symptom onset, and high suspicion of such cases should be kept  when patients have a history of minor trauma or bleeding disorders and especially  when the patient is elderly. Such cases necessitate immediate diagnosis via imaging  modalities of the intracranial hemorrhages and necessary intervention.