The Multifocal Cerebral Infarctions in Patient after Epidural Hematoma Evacuation

We report a patient who developed multiple focal cerebral infarctions after epidural hematoma evacuation. A 41-year-old man presented with altered mentality after sustaining a head trauma. Computer tomography (CT) scan showed large epidural hematoma at the left hemisphere. The patient underwent emergency evacuation of the hematoma and decompression surgery. Three days after the surgery, the patient showed right side hemiparesis. CT and MR diffusion weight images (MRDWI) revealed multiple infarctions at focal posterior cerebral artery (PCA) and middle cerebral artery (MCA) territories and subcortical parenchyma. Several months after the surgery, the patient showed improved mentality, but his cognition and hemiparesis were not improved as much. Before ischemic change occurs, it is vital to administer early, rapid and aggressive management are required to prevent posttraumatic cerebral infarction. (J Kor Neurotraumatol Soc 2010;6:66-69)