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A 80-year-old man was evaluated in a neurologic department for a gait disorder and a progressive cognitive impairment dating back about 6 months earlier. His pathologic history was unremarkable, except for a minor head injury 6 months before. The neurologic examination revealed neuropsychologic impairment of frontal type, a bilateral Babinsky and an ataxic–apraxic gait with frequent freezings. He also complained about a new onset bladder incontinence. An electroencephalogram showed a slow bi-hemispheric activity. Cranial computed tomography (CT) scan revealed bilateral chronic subdural haematoma with a notable compression of the brain (figs 1 and 2). The patient was successfully treated with surgical drainage of the subdural haematomas, and recovered fully from the disturbances.
This case emphasises the importance of a detailed case history, follow-up of elderly patients after a cranial injury, and the use of CT scan to exclude reversible causes of gait disorder or cognitive impairment.1,2
Competing interests: none.
Patient consent: Patient/guardian consent was obtained for publication
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