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Subdural hematoma and electroconvulsive therapy: A case report and review of the literature
Authors:C. Dauleac  F. Vinckier  P. Bourdillon
Affiliation:1. Department of neurosurgery, Hospices civils de Lyon, Hospital for neurology and neurosurgery Pierre Wertheimer, 69003, Lyon, France;2. Université de Lyon, Université Claude-Bernard, 69003, Lyon, France;3. Department of psychiatry, Sainte-Anne Hospital, 75014, Paris, France;4. Université Sorbonne Paris cité, Université René-Descartes, 75005, Paris, France;5. Inserm U1127, CNRS 7225, Brain and spine institute, 75006, Paris, France;6. Sorbonne Universités, université Pierre et Marie Curie, 75005, Paris, 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.
Keywords:Electroconvulsive therapy  Subdural hematoma  Depressive disorder  Drug resistant  Case report  CT-scan:  computed tomography scan  ECT:  electroconvulsive therapy  MRI:  magnetic resonance imaging  PD:  persistent depression  SDH:  subdural hematoma
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