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Spontaneous Subdural Hematoma due to Warfarin with Normal Prothrombin Time

Asian Journal of Pharmaceutical and Health Sciences,2013,3,2,677-679.
Published:May 2013
Type: Case Report
Author(s) affiliations:

Rudrajit Paul1, Avishek Das2, Jayati Mondal

1Assistant Professor 

2Junior Resident, Department of Medicine

3Junior Resident, Department of Gynaecology The West Bengal University Of Health Sciences, Medical College Kolkata,88, College Street, Kolkata-700073. West Bengal India.


Spontaneous subdural hematoma (SDH) is a rare entity. It can occur in patients with coagulopathy, hypertension or dehydration. Warfarin use causes inhibition of extrinsic coagulation pathway and predisposes to SDH. We here present a case of spontaneous SDH in a patient taking warfarin with normal Prothrombin time. He presented with seizure and abnormal behaviour. There was no clotting abnormality on routine tests. The importance of brain imaging in evaluating neurological symptoms in warfarinised patients is highlighted. The features of spontaneous SDH have been discussed.

Computed Tomographic scan of brain showing the left sided SDH with midline shift (arrow)