Atypical Finding of Subdural Hemorrhage

Subdural Hematoma is a type of intracranial bleeding, localized to the area between the two outer meninges of the brain, Dura mater and Arachnoid mater. It is often crescent shaped. The initial presentation of SDH has a wide spectrum of manifestations, extending from headache and vomiting to Focal neurological deficits. One of the rarest forms of post-traumatic intracranial hemorrhage is ‘'Isolated interhemispheric subdural hematoma (ISH)'' where the bleeding occurs due torsional forces rupturing the large fixed bridging veins draining from the parieto-occipital cortex to the superior sagittal sinus. ISH has a peculiar presentation known as the Falx Syndrome. Our patient presented with a history of fall sustained a laceration over the occipital region without any focal neurological deficit and no sensory abnormalities, CT scan of the brain was done which revealed subdural hematoma in the left frontal region. However, a peculiarity of this case was the subdural hemorrhage located along the flax anteriorly on CT. A repeat CT scan was done the next day, which revealed an interval reduction in the SDH along the falx, which is a relatively uncommon type of SDH. Our patient lacked the characteristic findings of SDH which made her require a conservative treatment approach rather than surgery. Her course of stay was uneventful and hence was discharged with clinical and hemodynamic stability