Mirror-image extradural hematomas (EDH) are bilaterally symmetrical and have same
anatomical location on either sides. These are very rare and associated with high
mortality unless managed emergently with surgical evacuation. Incidence of mirror-image
EDHs is approximately 1.7%. Bilateral EDHs are of two types based on the source of
bleeding. In the more common type, the bleeding source is venous and presents in a
delayed manner, whereas the second type has arterial bleeding and presents more acutely
and can deteriorate at an exceedingly fast pace. Quick decompression is the key in
these cases to improve the outcomes. The authors illustrate a case of mirror-image
EDH over parieto-occipital region that was evacuated surgically with bicoronal scalp
incision and separate bilateral parietal craniotomies with excellent outcome.
Keywords
extradural hematoma - bilateral - symmetrical - mirror-image
