# New onset contralateral acute epidural hematoma following decompressive craniectomy for an acute subdural hematoma: A report of 2 cases

## TL;DR

Two cases show rare but deadly contralateral acute epidural hematoma after decompressive craniectomy for subdural hematoma, highlighting the need for early detection.

## Contribution

Reports two rare cases of contralateral acute epidural hematoma following decompressive craniectomy for subdural hematoma.

## Key findings

- Contralateral acute epidural hematoma is a rare but fatal complication after decompressive craniectomy.
- Early recognition and treatment can significantly affect patient outcomes.
- Immediate post-operative CT scans and neurological monitoring are crucial for identifying this complication.

## Abstract

Contralateral acute epidural hematoma development following a decompressive craniectomy for an acute subdural hematoma is a rare but fatal complication. Early recognition and treatment can be lifesaving.

We present 2 cases of a new onset massive contralateral acute epidural hematoma development following decompressive craniectomy and hematoma evacuation for acute subdural hematoma, each with different course of the pathology and post-operative outcome.

Even after a decompressive craniectomy for a structural primary lesion, neurologic follow-up and immediate control CT scans of patients with severe traumatic brain injury (TBI) can help us identify this very uncommon complication. Additionally, these two cases demonstrate the significance of prompt detection and intervention, which can dramatically change the pathology's progression and neurologic outcome.