title: An atypical case of head trauma with late onset of contrecoup epidural hematoma, cerebellar contusion, and cerebral infarction in the territory of the recurrent artery of Heubner.
abstract: We encountered a case of head trauma with very unusual delayed events. A 68-year-old woman was admitted to our hospital after receiving a direct impact to her occiput in a traffic accident. Head CT scans showed a thin acute epidural hematoma in the posterior fossa corresponding to a linear fracture, followed by late onset of contrecoup left frontal epidural hematoma and subsequent cerebellar contusion in the right cerebellar hemisphere. Fifteen days after the trauma, the patient developed mild motor weakness of right upper extremity. MRIs demonstrated an infarct in the territory of the left recurrent artery of Heubner. Although rare, atypical late events in patients with head trauma as reported here should be taken into consideration during subacute follow-up periods.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, 477-96 Owada-Shinden, Yachiyo-shi, Chiba 276-8524, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Sato
authors.forename: Tetsuryu
authors.initials: T
authors.lastname: Mitsuyama
authors.forename: Akira
authors.initials: A
authors.lastname: Ishii
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
mesh_terms: D000063:Accidents, Traffic; D000368:Aged; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D001924:Brain Concussion / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D002531:Cerebellum / Q000293:injuries* / Q000473:pathology; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D007839:Functional Laterality / Q000502:physiology; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D010291:Paresis / Q000209:etiology; D012887:Skull Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed