Recurrent Subacute Subdural Hematoma in a 67-Year-Old Female with Late Alzheimer’s Disease: A Case Report


  • Paul Marcel Morgan E-Da Hospital



Chronic Subdural Hematoma, Alzheimer Disease, Trephining


Background: Chronic Subdural Hematoma (CSDH) is becoming an urgent public health issue due to an increase of incidence in aging populations like Taiwan. Though trauma still stands as the primary mechanism of CSDH, it is often overlooked in the elderly, especially those with mid-to-late stage Alzheimer’s Disease (AD). Coincidentally, the clinical presentation of mid-to-late stage AD shares significant overlap with CSDH. AD creates an immense challenge for physicians and family members to identify early signs of CSDH.

The Case: We report a peculiar case of a 67-year-old female with a history of AD who presents to the Emergency room in Belmopan City, Belize, with recurrent CSDH. On admission her consciousness was disturbed and late stage dementia presented an enormous challenge for logical and meaningful history taking. Axial non-contrast computed tomography showed a crescent-shaped isodense subdural hematoma in the left hemisphere of the parietal lobe. She was stabilized and treated conservatively with corticosteroids, beta blockers, angiotensin-converting enzyme (ACE) inhibitors and diuretics.

Conclusion: It is important for physicians to recognize and develop protocols to identify early signs of CSDH in patients with late stage AD. Early management is a key factor in minimizing more serious complications like recurrence, seizures, and tension pneumocephalus.


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Adhiyaman V, Asghar M, Ganeshram KN, Bhowmick BK. Chronic subdural haematoma in the elderly. Postgrad Med J. 2002 Feb;78(916):71-5.

Bature F, Guinn B-A, Pang D, Pappas Y. Signs and symptoms preceding the diagnosis of Alzheimer's disease: a systematic scoping review of literature from 1937 to 2016. BMJ Open. 2017 Aug 28;7(8):e015746.

Prystupa A, Kurys-Denis E, Łopatyński T, Baraniak J, Krupski W, Nogalski A, et al. Chronic subdural haematoma in a patient with arterial hypertension and Alzheimer’s disease. J Pre Clin Clin Res. 2009;3(2):127-9.

Mijajlović MD, Pavlović A, Brainin M, Heiss W-D, Quinn TJ, Ihle-Hansen HB, et al. Post-stroke dementia - a comprehensive review. BMC Med. 2017 Jan 18;15(1):11.

Kuwahara S, Kawada M, Uga S. Chronic subdural hematoma with vasogenic edema in the cerebral hemisphere--case report. Neurol Med Chir (Tokyo). 2001 Apr;41(4):196-200.

Sahyouni R, Tran D, Chen J. The effects of subdural hematoma on dementia, and a posible pathophysiological mechanism via blockage of dural lymphatics. Alzheimers Dement. 2016 July 24;12(7):P562.

Edlmann E, Giorgi-Coll S, Whitfield P, L. H. Carpenter K, J. Hutchinson P. Pathophysiology of chronic subdural haematoma: Inflammation, angiogenesis and implications for pharmacotherapy. J Neuroinflammation. 2017 May 30;14(1):108.

Uno M, Toi H, Hirai S. Chronic Subdural Hematoma in Elderly Patients: Is This Disease Benign? Neurologia medico-chirurgica. Neurol Med Chir (Tokyo). 2017 Aug 15;57(8):402-9.

Yadav YR, Parihar V, Namdev H, Bajaj J. Chronic subdural hematoma. Asian J Neurosurg. 2016 Oct-Dec;11(4):330-42.

Duong S, Patel T, Chang F. Dementia: What pharmacists need to know. Can Pharm J (Ott). 2017 Feb 7;150(2):118-129.

Li X-L, Hu N, Tan M-S, Yu J-T, Tan L. Behavioral and psychological symptoms in Alzheimer's disease. BioMed research international. 2014; 2014: 927804.

Burns A, Iliffe S. Alzheimer’s disease. BMJ. 2009 Feb 5;338:b158.



How to Cite

Morgan, P. M. (2019). Recurrent Subacute Subdural Hematoma in a 67-Year-Old Female with Late Alzheimer’s Disease: A Case Report. International Journal of Medical Students, 7(2), 38–40.



Case Report