Subdural Hematoma (SDH) Leading to Rapid Deterioration in a Patient with Alzheimer’s Disease


CT BRAIN showing right hemispheric subacute to chronic subdural hematoma. In addition, cerebral atrophy of left cerebral hemisphere is also noted.
Right sided SDH and left cerebral atrophy on CT Brain

70-year old man was brought with a history of progressive cognitive impairment of one year duration. However, there was a rapid deterioration of symptoms for the past few weeks. CT brain showed right sided subacute to chronic subdural hematoma (SDH). In addition, CT brain also showed cerebral atrophy on the left side. PET scan was also done, which showed features of Alzheimer’s disease.

In this case, there is a dual pathology. In a patient with pre-existing dementia due to Alzheimer’s disease, a rapid deterioration of cognitive functions were noted due to subdural hematoma. He was referred to Neurosurgeon for evacuation of SDH.

In a patient presenting with dementia, our first aim is to investigate for any treatable causes of dementia. Chronic SDH is one of the treatable causes of dementia.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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