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Neurochirurgie
Volume 65, n° 1
pages 40-42 (février 2019)
Doi : 10.1016/j.neuchi.2018.11.001
Received : 27 April 2018 ;  accepted : 22 November 2018
Cas cliniques courts

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

C. Dauleac a, b, , F. Vinckier c, d, e, P. Bourdillon a, b, e, f
a Department of neurosurgery, Hospices civils de Lyon, Hospital for neurology and neurosurgery Pierre Wertheimer, 69003, Lyon, France 
b Université de Lyon, Université Claude-Bernard, 69003, Lyon, France 
c Department of psychiatry, Sainte-Anne Hospital, 75014, Paris, France 
d Université Sorbonne Paris cité, Université René-Descartes, 75005, Paris, France 
e Inserm U1127, CNRS 7225, Brain and spine institute, 75006, Paris, France 
f Sorbonne Universités, université Pierre et Marie Curie, 75005, Paris, France 

Corresponding author. Department of Neurosurgery, Pierre Wertheimer hospital, hospices civils de Lyon, 59, boulevard Pinel, 69003, Lyon, France.France
Abstract
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.

The full text of this article is available in PDF format.

Keywords : Electroconvulsive therapy, Subdural hematoma, Depressive disorder, Drug resistant, Case report

Abbreviations : CT-scan:, ECT:, MRI:, PD:, SDH:




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