Chronic Subdural Hematoma After Decompressive Craniotomy for Acute Epidural Hematoma: A Case Report

Introduction: The formation of a chronic subdural hematoma at the same surgical site after evacuation of an extradural hematoma is a rare phenomenon. This article discusses a rare case in which a chronic subdural hematoma developed following decompressive craniectomy performed to treat an acute epidural hematoma. Case Presentation: We report the case of a 61-year-old male patient who underwent surgery in December 2024 for evacuation of a left parietal extradural hematoma. The patients presented with symptoms, including headache, confusion, and focal neurological deficits, which were indicative of a chronic subdural hematoma. Computed tomography revealed a crescent-shaped hypodense lesion over the convexity of the brain, characteristic of chronic subdural hematoma. Discussion: The development of chronic subdural hematoma after decompressive craniotomy may be due to factors such as brain re-expansion, changes in intracranial pressure, and the formation of new blood vessels in the subdural space. The patients underwent surgical evacuation of the chronic subdural hematoma via a burr hole procedure, which led to the resolution of symptoms and improved neurological function. Conclusion: Maintaining a high index of suspicion is essential, particularly in patients who develop delayed neurological symptoms. Establishing standardized follow-up and imaging protocols may help prevent delayed diagnoses and improve overall patient outcomes.