MISSED SUBDURAL HAEMATOMA IN AN ELDERLY PATIENT INITIALLY DIAGNOSED WITH MILD TRAUMATIC BRAIN INJURY: A CASE REPORT

Subdural haematoma is an important cause of morbidity and mortality among elderly patients and may be difficult to recognize following apparently minor head trauma. Clinical presentation can be subtle, and significant intracranial pathology may occur despite a normal level of consciousness. We report the case of a 79-year-old man who presented with a two-week history of progressively worsening headache following an initial diagnosis of mild traumatic brain injury. On reassessment, his Glasgow Coma Scale score was 15/15. Cranial computed tomography subsequently demonstrated a left cerebral hemisphere subacute subdural haematoma associated with contralateral midline shift and a right cerebral hemisphere acute-on-chronic subdural haematoma. The patient underwent surgical evacuation through burr-hole drainage and subsequently achieved full recovery. This case highlights the importance of maintaining a high index of suspicion for subdural haematoma in elderly patients with persistent or worsening symptoms after head trauma, even when the patient has a normal GCS. Early neuro-imaging and timely neurosurgical intervention are important in preventing neurological deterioration and improving outcomes.