Bifrontal Extradural Hematoma (EDH) Causing Isolated Right 3rd Nerve Palsy with Spontaneous Partial Recovery

All neurosurgeons are aware of traumatic intracranial hematomas presenting with oculomotor nerve palsy which requires immediate surgical intervention. Isolated third nerve palsy with no other neurological signs due to head injury is a rare occurrence. We report a case of head injury with bifrontal extradural hematoma presenting as  isolated right sided  third nerve palsy which partially improved with nonsurgical management. We also discuss the possible causes of such involvement.

Remote Acute Extradural Hematoma Formation after Ventriculoperitoneal Shunt - A Rare Occurrence

Formation of acute epidural hematoma after Ventriculoperitoneal shunt insertion is rare in adults, more so at a site remote from the site of shunt insertion. We are presenting such a rare occurrence and discussing possible factors involved in this complication. A 35-year-old male was diagnosed with a third ventricular colloid cyst with hydrocephalus. A Ventriculoperitoneal medium pressure shunt was placed through right Keen point burr hole and the patient developed a right frontal extradural hematoma on the 4th post-operative day which was subsequently evacuated by craniotomy and the patient recovered fully thereafter. Acute extradural hematoma is a potentially life threatening complication. High index of suspicion, precautions during shunt insertion and early detection can prevent mortality and severe morbidity in these cases.