A 79 year-old man was changing a light bulb and his home when he fell from the chair on which he was standing.

He struck his head, but complained only a headache.

• However, he became drowsy about an hour, and began to show muscular weakness on the left side.

• He was brought to hospital and a CT scan revealed a right-sided subdural hematoma.

• His Glasgow Coma Scale was reported to have a score of 10.

Measurement of intracranial pressure with the surface transducer yielded a value of about 20 mm Hg.

Since his condition did not improve, it was decided that surgical evacuation of the hematoma should be performed

case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center
case editor: Michael Gordon, Ph.D.