Expecting the unexpected; Walk-in chronic subdural hematomas
Chronic subdural hematomas can often be an elusive and devastating diagnosis. Learning to recognise them is often helped by the study of various cases and the ways in which they have presented in the past. When the neurological symptoms are devastating its easier to assume there is a large intracranial bleed but what about walk in patients who initially seem to have minor complaints? This is a comparative study of two such cases in our emergency department with vastly different presenting symptoms, both of whom were found to be suffering from chronic subdural hematomas (SDH) of varying ages. Both patients had significant bleeds from different traumatic incidents which had occurred in the weeks prior (5 and 2 weeks respectively), one patient having the added complication of being treated with an oral anticoagulant. A fascinating discussion of the difference in symptomatology, the clinical reasoning behind the imagistic studies performed and the CT scans themselves which, despite being with the same diagnosis, had their own peculiarities.
