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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2018

Open Access 01-12-2018 | Case report

Acute contrecoup epidural hematoma that developed without skull fracture in two adults: two case reports

Authors: Shunpei Andoh, Chie Matsuura, Yuuki Sakaeyama, Shinichi Okonogi, Yasuhiro Node, Hiroyuki Masuda, Kousuke Kondo, Naoyuki Harada, Masaaki Nemoto, Nobuo Sugo

Published in: Journal of Medical Case Reports | Issue 1/2018

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Abstract

Background

The incidence of acute epidural hematoma not accompanied by fracture is low, and it mostly occurs right below the impact point in children. Acute epidural hematoma on the contralateral side of the impact point without fracture is very rare.

Case presentation

Case 1: a 52-year-old Japanese woman fell and was bruised in the left occipital region, and acute epidural hematoma developed in the right frontal region. No fracture line was observed in the right frontal region on head computed tomography or during surgery, and the source of bleeding was the middle meningeal artery. Case 2: a 56-year-old Japanese man fell down the stairs and was bruised in the right occipital region, and acute epidural hematoma developed in the right occipital supra- and infratentorial regions and left frontal region. Separation of the lambdoid suture was noted in the right occipital region, but no fracture line was present in the left frontal region on either head computed tomography or during surgery, and the source of bleeding was the middle meningeal artery.

Conclusions

Two rare cases of frontal contrecoup acute epidural hematoma without facture near the hematoma were reported. It is possible that the dura mater detaches from the inner surface of the skull due to cavitation theory-related negative pressure and blood vessels in the dura mater are damaged, causing contrecoup acute epidural hematoma even though no fracture occurs, for which careful course observation is necessary.
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Metadata
Title
Acute contrecoup epidural hematoma that developed without skull fracture in two adults: two case reports
Authors
Shunpei Andoh
Chie Matsuura
Yuuki Sakaeyama
Shinichi Okonogi
Yasuhiro Node
Hiroyuki Masuda
Kousuke Kondo
Naoyuki Harada
Masaaki Nemoto
Nobuo Sugo
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-018-1676-1

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