Acute Subdural Hematoma during Tack-up Suture of the Dura Mater

A rare neurosurgical event is described, in which an acute subdural hematoma developed during tack-up suture of the dura mater after evacuation of an acute epidural hematoma. The source of the second hematoma was determined to have been a ruptured bridging vein. The author discusses the potential risk of tack-up suture when there is a large gap between the dura mater and the inner surface of the skull.