Asymmetric Bilateral Traumatic Epidural Hematoma: A Report of a Rare Traumatic Lesion

不对称性双侧创伤性硬膜外血肿:一例罕见创伤性病变的报告

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Abstract

Bilateral epidural hematoma is a rare presentation in head trauma injuries, accounting for only 1%-2% of all epidural hematomas, but with a higher mortality rate than the unilateral form. Herein, we report the case of a 27-year-old man admitted to our department following a road traffic accident. On admission,his Glasgow Coma Scale (GCS) score was 13/15. After a few minutes, he became comatose (GCS 6/15) with right anisocoria. CT scan revealed a bilateral asymmetric epidural hematoma with a left extralabyrinthic linear fracture. Surgical evacuation was subsequently performed, starting with the voluminous right hematoma. The patient was discharged on the 23rd postoperative day with a right third-nerve palsy. Conclusions: In this case report, we discuss the etiology, mechanism, and management of bilateral epidural hematoma. Early diagnosis and a judicious surgical approach for bilateral epidural hematoma are necessary to minimize mortality and morbidity. Prevention is key to reducing traumatic brain injuries.

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