A 5-year-old male suffered a head injury after falling from a height of 2 meters. Upon admission, five hours after the accident, he had a Glasgow Coma Scale (GCS) of 15. Brain computed tomography (CT) revealed an epidural hematoma (EDH) in the right temporoparietal area and a subdural hematoma (SDH) in the left temporal area (), as well as a skull fracture in both temporal bones. Emergency right craniotomy was performed and the EDH was evacuated. The underlying dura was loose and depressed. Intraoperative TCS applied to the right craniectomy site revealed no expansion of the left side hematoma (). The damaged meningeal artery was coagulated, dural tacking sutures were placed to prevent EDH re-accumulation, and the bone flap was repositioned.\nAfter confirming no change in the contralateral hematoma volume by postoperative brain CT immediately after surgery, the patient was admitted to the intensive care unit. After arousal, his GCS score had not changed. The patient was discharged on hospital day 13 with no definite neurological deficit.
A 30-year-old male, presented after an hour following trauma, with a Glasgow Coma Scale (GCS) score of 6/15 and symmetric and reacting pupils. Computed tomography (CT) scan of the brain showed an acute SDH in the right fronto-temporo-parietal region with mass effect and midline shift []. There were linear fractures of the ipsilateral parietal, temporal, and occipital bones with pneumocephalus, in the vicinity, of the right transverse sinus []. He underwent emergency craniotomy and evacuation of the SDH. A lax duroplasty, was done and the bone flap not replaced, as the brain was tense. He remained neurologically stable on ventilator support, with symmetric and reacting pupils. A routine follow-up CT scan of the brain after 24 h showed an ipsilateral EDH straddling the transverse sinus, causing mass effect and herniation of the brain through the craniectomy defect []. He underwent emergency craniotomy and evacuation of the hematoma. His extended glasgow outcome score (GOS-E) was 8 (upper good recovery), at 6 months.