Acute Subdural Hematoma in a Judo Player with Repeated Head Injuries

Abstract

Background: Acute subdural hematoma (ASDH) is the most important cause of severe head injuries occurring during judo practice in Japan. Repeated head injuries have been reported as a cause of fatal ASDH, although the mechanism remains unknown.

Case description: A 16-year-old boy visited an emergency department with vomiting 3 days after a strong blow to the occipital region during judo practice. Although computed tomography was performed at that time, a small interhemispheric ASDH was overlooked. The patient sustained another head injury 19 days after the first, which led to convulsions and disturbance of consciousness. The ASDH was increased in size on computed tomography. We performed a surgical evacuation, which revealed tearing of a bridging vein, after which the patient showed a good recovery.

Conclusions: It is important to be aware of the possibility of a small ASDH in concussed judo players after an initial impact, which may lead to subsequent fatal ASDH after another impact incident.

Keywords: Acute subdural hematoma; Concussion; Head injury; Judo.