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.
A 51-year-old female was admitted with a head injury after a pedestrian accident. Upon admission, one hour after the accident, she had a GCS of 14. Brain CT revealed an EDH in the right temporoparietal area, SDH in the left frontal area (), and skull fracture in the right temporal and left frontal bone. Emergency right craniotomy was performed and the EDH was evacuated. Softened dura matter was found after performing craniectomy. Intraoperative TCS applied to the craniectomy site revealed volume expansion of the EDH in the left frontal area (). The bone flap was repositioned. Her vital signs were stable, and she was transported to the CT room. Brain CT confirmed the presence of a de novo EDH in the left frontal area. As a result, a second operation was performed on the left side. Her postoperative GCS score was 14, and the patient was discharged on hospital day 20 with no definite neurological deficit.