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New-onset contralateral delayed extradural haematoma in an operated case of extradural haematoma: life-threatening if not diagnosed early
  1. Rajkumar Pannem1,
  2. Rajasekhar Rekhapalli2,
  3. Garga Basu1 and
  4. Rajnish Arora1
  1. 1Neurosurgery, All India Institute of Medical Sciences - Rishikesh, Dehradun, Uttarakhand, India
  2. 2Neurosurgery, All India Institute of Medical Sciences - Mangalagiri, Vijayawada, Andhra Pradesh, India
  1. Correspondence to Dr Rajkumar Pannem; pannem16{at}


Head trauma is still a leading cause of mortality in neurosurgical practice. Among various post-traumatic pathologies, extradural haematoma (EDH) is an acute condition that has good neurological outcomes if intervened promptly. New contralateral delayed EDH (DEDH) in an operated case of ipsilateral EDH is a very rare entity, which if not diagnosed timely may lead to devastating outcomes, sometimes even death. We present a case of newly found contralateral DEDH with significant mass effect and midline shift in the immediate postoperative scan, in an operated case of right frontoparietal EDH, which was not found in the initial preoperative scan. A high index of suspicion is needed in cases of unilateral EDH with contralateral skull fracture along with tense dura after the evacuation of EDH, to diagnose rare but life-threatening contralateral DEDH. Routine immediate postoperative CT scan will prevent devastating complications in these kinds of patients.

  • Neuroimaging
  • Trauma

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  • Contributors RP: acquisition of data, assisting surgeon and reporting. RR: operating surgeon and planning. GB: assisting surgeon and planning. RA: conception and design.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.