Bilateral Cerebral Ischemia after Epidural Hematoma Evacuation

Background: Unilateral Cerebral Ischemia after Epidural Hematoma (EDH) evacuation is well documented in the literature. We are reporting a case of Epidural Hematoma evacuation, resulting in cerebral ischemia bi-laterally. Case Report: A 42-year-old male presented to the ER with a history of road traffic accidents. Arrival GCS was 7/15. A CT scan brain showed a huge left-side EDH involving frontal, parietal, and temporal regions. On the right side, there were contusions in the frontal area. EDH was evacuated surgically. The patient’s GCS improved after 2 days but deteriorated afterward. Repeat CT shows the expansion of contusions and developing ischemia on both sides involving MCA and PCA territories. Contusions were surgically removed and ischemia was treated conservatively. After a couple of weeks, the patient improved. Conclusion: Cerebral Ischemia does develop after epidural hematoma evacuation, so the contusions on the conta-lateral side expand. Therefore close monitoring of such patients and timely surgical evacuation are necessary in preventing complications. Keywords: Epidural hematoma, Cerebral Ischemia, Head Injury, Complications.c