title: Delayed Acute Subdural Hematoma Associated With Percutaneous Coronary Intervention.
abstract: BACKGROUND
  Delayed acute subdural hematoma (DASH) is a subdural hematoma which is detected later. An initial computed tomography (CT) does not reveal any intracranial hemorrhage at all. Few patients of DASH after mild traumatic brain injury associated with percutaneous coronary intervention (PCI) have been published.
  
  
  METHODS
  A 63-year-old woman presented with cardiac pulmonary arrest due to acute myocardial infarction and lethal arrhythmia. She had hit her head on the road. The initial CT did not reveal any hemorrhage in the intra-cranium. She fully recovered after PCI. However, 1 hour after PCI, she lost consciousness and immediate CT showed acute subdural hematoma and subarachnoid hemorrhage. The period from losing consciousness to brain herniation presenting as anisocoria was very short-only 30 minutes in our patient. Although emergent evacuation of hematoma and external decompression were performed, the patient died 1 day after the operation.
  
  
  CONCLUSIONS
  The authors encountered a patient of DASH after PCI that resulted in death. Clinicians should be aware that subdural hemorrhage can occur after PCI if no hemorrhage is noted in the initial head CT, and the operation should be performed as soon as possible when the consciousness level decreases.
authors.affiliation: Department of Neurosurgery, Hiratsuka City Hospital, Minamihara, Hiratsuka City, Kanagawa, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Arai
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Nakamura
authors.forename: Masanao
authors.initials: M
authors.lastname: Tabuse
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Miyazaki
mesh_terms: D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020199:Hematoma, Subdural, Acute / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D013997:Time Factors