Subdural hematoma and electroconvulsive therapy: A case report and review of the literature.

Neurochirurgie

Department of neurosurgery, Hospices civils de Lyon, Hospital for neurology and neurosurgery Pierre Wertheimer, 69003, Lyon, France; Université de Lyon, Université Claude-Bernard, 69003, Lyon, France; Inserm U1127, CNRS 7225, Brain and spine institute, 75006, Paris, France; Sorbonne Universités, université Pierre et Marie Curie, 75005, Paris, France.

Published: February 2019

Background And Case Presentation: Electroconvulsive therapy (ECT) is a common therapeutic procedure in psychiatry associated with a low rate of complications. We report a rare case of subdural hematoma (SDH) associated with ECT.

Clinical Presentation: a 64 year old woman, with a medical history of persistent depression which required ECT six years previously, underwent ECT following a new acute episode. After four ECT sessions, a left hemiparesis occurred. Brain CT scan revealed a right SDH. The patient underwent surgery and fully recovered three months after the drainage of the hematoma. We conducted a review of all cases in which SDH was associated to ECT.

Conclusion: Early stage brain imaging is indispensable prior to starting ECT. Moreover, a previous medical history of SDH may not be a contraindication to ECT. In these situations, a clinical and radiological follow-up by both the psychiatrist and the neurosurgeon during all the ECT sessions is highly recommended.

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http://dx.doi.org/10.1016/j.neuchi.2018.11.001DOI Listing

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