[Interhemispheric subdural hematoma].

Although relatively uncommon, interhemispheric subdural hematoma (ISDH) occurs more frequently than was suspected before the advent of computerized tomographic (CT) scanning. When its mass is sufficiently large to compress the medial cerebral hemisphere, specific focal neurological abnormalities may occur. These include weakness of the contralateral leg, or contralateral hemiparesis with the leg being weaker than the arm. On the unenhanced CT scan ISDH is seen as a crescent shaped, midline hyperdensity. Treatment is dictated by the clinical course. Evacuation of the hematoma by parasagittal craniotomy is recommended if the symptoms are pronounced. RESUME: Hematome sous-dural interhemispherique Meme si cette entite est relativement rare, I'hematome sousdural interhemispherique (HSDI) survient plus frequemment qu'on ne le soup§onnait avant l'avenement de la tomographic axiale assistee par ordinateur. Quand la masse de I'hematome est suffisamment importante pour comprimer la face interne de l'hemisphere, des anomalies neurologiques focales specifiques apparaissent. Parmi celles-ci, notons la faiblesse de la jambe contralaterale ou l'hemiparesie contralaterale, la jambe etant plus faible que le bras. A la tomographic axiale sans perfusion de produit de contraste, l'HSDI apparait comme une zone d'hyperdensite m£diane en forme de croissant. Le traitement est determine par revolution clinique. Si la symptomatologie est importante, il est recommande de proceder a l'evacuation de I'hematome par craniotomie parasagittal. Can. J. Neurol. Sci. 1987; 14:172-174 Interhemispheric subdural hematoma (ISDH) was first described at autopsy by Airing and Evans' in 1940 and first recognized during life by Jacobsen in 1955. Prior to the advent of computerized tomographic (CT) scanning this lesion was very difficult to detect, a fact which accounts for the paucity of cases reported before 1974," and for the persistent belief that it is very rare". In this paper we report two additional cases of ISDH and discuss the unique features of this lesion.

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