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Washington University Experience | VASCULAR | Hemorrrhage - Subdural | 1A0 Case 1 History
Case 1 History ---- The patient was a 76 year old woman who was brought to the ER 2 weeks prior to her death with hematuria followed by decreased responsiveness and left facial weakness resulting in drooling. She was profoundly dehydrated, stuporous and responsive to deep pain only. Examination of extremities showed mild weakness in the left arm. Reflexes were present and symmetrical with plantar Babinski responses. The patient was treated symptomatically and given antibiotics for her urinary tract infection. She was discharged with her mental state only slightly improved. Two weeks later she returned to the ER on arrival after a one day history of shallow respirations. ---- At autopsy the unfixed brain weighed 1100g. Chronic bilateral subdural hematomas were noted on removal of the brain with the right subdural space containing clear xanthochromic fluid, while the left subdural space included formed clotted elements. After fixation, the dural membrane contained well-formed and thickened internal subdural pseudomembranes which were firmly adherent to the dura at their margins. The ventricular system showed rounding of the lateral borders, however, they were not frankly enlarged. The patient met and exceeded pathologic requirements for Alzheimer disease using all diagnostic schemes.
