Spontaneous Subdural Hemorrhage in a Cirrhotic Patient: A Diagnostic Dilemma: A Case Report

REPORTside, and anisocoria.An emergency computed tomography (CT) head was performed, revealing left-sided acute SDH with a midline shift of 13.5 mm (Fig. 1).He was electively intubated due to the worsening GCS.The initial blood panel showed a platelet count of 75,000/mm 3 , international normalized ratio (INR) 1.4, prothrombin time (PT) 15 seconds, and serum ammonia levels, electrolytes, urea, and blood sugars were within limits.A neurosurgery consult was obtained, and the patient underwent burr hole placement and SDH evacuation under general anesthesia.Follow-up CT brain showed resolution of SDH and midline shift (Fig. 2).The perioperative period was uneventful, and the patient was weaned off ventilator support.On postoperative day 2, the patient's GCS improved to 12/15.Regular limb physiotherapy, nutrition, and other supportive care were provided.On postoperative day 3, the patient's GCS improved to 15/15, oral feeding was initiated, and the patient was able to walk with support.The patient developed alcohol withdrawal and was 1,2,