• Masaru Idei, Takeshi Shima, Masahiro Nishida, Kanji Yamane, Chie Mihara, Takashi Hatayama, Hidetaka Onda, Kazufumi Manabe, and Akira Yokota.
• Department of Neurosurgery, Chugoku Rousai Hospital, 1-5-1 Hiro-tagaya, Kure-shi 737-0193, Japan.
• No Shinkei Geka. 2004 Apr 1; 32 (4): 379-82.

AbstractThe authors presented a patient with acute symmetrical bilateral epidural hematomas, which are rare but life threatening. A 72-year-old male accidentally fell from the roof at a height of about 3 meters and hit his head against the ground. He was transferred to the emergency ward in our hospital. On admission, he was alert and had no neurological deficits. Skull X-ray film revealed a depressed fracture in the mid parietoocipital region and bilateral linear fractures extending from the parietal regions to the temporal regions. CT scan showed symmetrical bilateral epidural hematomas in the both parietotemporal regions. His consciousness deteriorated to be drowsiness about one hour after admission. An additional CT scan revealed enlargement of the both epidural hematomas and impending tentorial herniation. Therefore, an emergency operation was called for. For rapid decompression of the brain, bilateral craniotomies were carried out simultaneously by the two neurosurgeon-groups involved and bilateral epidural hematomas were also simultaneously removed. Injury of both of the middle meningeal arteries was revealed to be the cause of the bilateral epidural hematomas. Clinical course after operation was uneventful and the patient was discharged without any neurological deficit. Simultaneous bilateral craniotomies and removal of the epidural hematomas would have contributed to obtaining the good result in this patient.

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