A spontaneous chronic subdural hematoma in a boy after lifting a heavy object: a case report

Abstract

Background: Subdural hematoma (SDH) is the accumulation of blood below the inner layer of the dura but external to the brain and arachnoid membrane. Chronic SDHs (cSDHs) are well documented in infants where it is frequently observed as a single entity but rare beyond infancy. Variable clinical manifestations may result, including headache, nausea or vomiting, mental status change, seizure, weakness, sensory disturbance, gait abnormality, and coma. Case Presentation: The current report presents a case of a 10-year-old boy, medically free, who presented to the emergency department complaining of bilateral generalized lower limb pain, headache, nausea, and vomiting. The patient reported that symptoms started following lifting a heavy object 2 days ago at school. All labs were normal. Physical examination was normal. Urgent head computed tomography showed a left-sided subdural collection. Urgent surgical evacuation was done, and the patient had a full recovery. The patient was discharged after 2 days and followed up within 1 month. Conclusion: Subdural bleeding can be triggered by a sudden rise in intravenous pressure. Early diagnosis and treatment with craniotomy and drainage revealed an excellent prognosis.