• Edmundo Luis Rodrigues Pereira, Daniella Brito Rodrigues, Lorena Oliveira Lima, Luis Armando Sawada, and Mário de Nazareth Hermes.
• Neurosurgeon, Department of Neurological Surgery, Metropolitan Hospital of Urgencies and Emergencies, Belém, PA, Brazil.
• Surg Neurol Int. 2015 Jan 1; 6: 14.

BackgroundAcute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5-10% of all extradural hematomas. However, higher mortality rates have been reported in previous series.Case DescriptionThe authors described the case of a 28-year-old male presenting head injury, comatose, Glasgow Coma Scale of 6, anisocoric pupils without puppilary light reflex. Computed tomography showed asymmetric bilateral epidural hematomas, effacement of the lateral ventricles and sulci, midline shift and a bilateral skull fracture reaching the vertex. Surgical evacuation was performed with simultaneous hematoma drainage. Patient was discharged on the 29(th) postoperative day with no neurological deficit.ConclusionThe correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage.

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