Hematoma subdural diagnosticado como ingesta medicamentosa en paciente con esquizofrenia

Objective

To underline the importance of thorough examination in diagnosing intraparenchymal processes in patients with a history of psychiatric disease.

Clinical case

A 56-year-old male with a history of schizophrenia was taken to the emergency department with somnolence, difficulty in walking and right-arm tremor. The internal medicine department suspected to be secondary neurological symptoms after attempted to self-harm through ingestion of drugs.

Results

After the psychiatric department had examined the patient's mental state, a CT scan was performed that revealed an acute subdural haematoma (ASH). Cortical atrophy in patients with schizophrenia favours the accumulation of intracerebral blood and a delay in the symptoms and diagnosis of these processes, increasing the risk to life.

Conclusions

Accurate anamnesis and brain imaging tests are essential for the differential diagnosis of ASH in patients with schizophrenia.