Posterior fossa subdural hematoma resulting in locked-in syndrome: case report.

Abstract

Locked-in syndrome (LIS) is a well-known and devastating clinical entity, of which stroke is the most common cause; the distant second, trauma, usually results in LIS from basilar artery dissection. Our case report describes a posterior fossa subdural hematoma causing LIS, likely by direct compression of neural structures, which is a unique etiology and prognosis compared with other causes. A 34-year-old female experienced a posterior fossa subdural hematoma. She was taken emergently for evacuation, and on postoperative examination was found to be locked-in. The symptom complex, while classic for LIS, resolved at an accelerated rate compared with previous reports. Emergent evacuation of clot and rehabilitation were performed. Prompt treatment allowed this patient to experience an accelerated and more complete recovery compared with the ischemic causes of LIS.