Acute Subdural Hematoma Presented with Dizziness
 
Hsuan-Min Kao¹, En-Fan Chang², Ya-Lun Yu¹, Nai-Hua Hsu³ and Jun-Jun Yeh¹

Population aging has become a trend in Taiwan, and dizziness is commonly reported by older adults. We present the case of a 66-year-old woman with a history of hypertension, diabetes mellitus, hyperlipidemia, and mitral valve prolapse who reported persistent dizziness for 3 hours just after syncope and hitting the back of her head on a table. On arrival, she was fully conscious and well oriented, and all results of neurological examination [including Glasgow Coma Scale (GCS), Mini-Mental State Examination (MMSE), cranial nerves test, muscle power, and Babinski sign] and physical examination were normal. However, because of her age (>60 years), she was at high risk for brain hemorrhage after the trauma. She underwent brain computed tomography, which revealed acute subdural hematoma (SDH). Thence, we report a case of acute SDH in an older patient that initially presented as only persistent dizziness after head trauma.
(Taiwan J Fam Med 2020; 30: 98-106) DOI: 10.3966/168232812020063002005
 
Key words: acute subdural hematoma, dizziness, elder patient, head trauma
 

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¹Departments of Family Medicine, ²Medical Imaging, ³Post Graduate Year, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Received: December 31, 2019; Revised: Mach 17, 2020; Accepted: April 4, 2020.
Correspondence to: Dr. Hsuan-Min Kao, Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital. No.539, Zhongxiao Rd., East Dist., Chiayi City 60002, Taiwan (R.O.C.) E-mail:07508@cych.org.tw
 

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以頭暈為初始表現的急性硬腦膜下血腫
 
高玄旻¹　張恩凡²　余亞倫¹　許乃驊³　葉俊濬¹

我們報告一位66歲的女性病人，她過去病史有高血壓，糖尿病，高血脂症和二尖瓣脫垂，來門診的主訴為在3小時前昏倒並撞到頭後的持續性頭暈。她意識清楚且定向良好，所有神經檢查結果（包括格拉斯哥昏迷量表、簡短智能測驗、顱神經檢查，肌力評估和巴賓斯基反射）和其他身體檢查均為正常。但由於年齡大於60歲，她在外傷後有相對高風險會發生腦出血。因此安排她做腦部電腦斷層，並發現了急性硬腦膜下血腫。在台灣，人口老齡化已成為一種趨勢，而頭暈為老年患者常見的主訴，且其原因也多樣化。因此藉由此病例分享，在面對老年患者頭部外傷後的頭暈時，須謹慎評估其伴隨的併發症。
（台灣家醫誌2020; 30: 98-106）DOI: 10.3966/168232812020063002005
 
關鍵詞：老年患者、頭部外傷、頭暈、急性硬腦膜下血腫
 

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¹戴德森醫療財團法人嘉義基督教醫院家庭醫學科、²影像醫學科、³一般醫學科
受理日期：108年12月31日　　修改日期：109年3月17日　　同意刊登：109年4月4日