A 54-year-old man presented with unconsciousness for 2 hours after head trauma. Brain CT revealed vanished epidural hematoma and expanded subdural hematoma compared with brain CT performed 1 hour before (Figure). An operation plan to evacuate the left subdural hematoma and then the right subgaleal hematoma was made.¹ However, respiratory and cardiac arrest occurred, accompanied by lasting hypotension, and blood test revealed acute disorders of coagulation and decreased platelets contraindicating surgery. He received conservative treatment and died 36 hours after trauma. Although rare, acute epidural hematoma total shifts into subgaleal hematoma could occur because of rapidly increased intracranial pressure in patients with coagulation disturbance.

一名 54 岁男性，头部外伤后昏迷 2 小时。与 1 小时前进行的脑 CT 相比，脑 CT 显示硬膜外血肿消失，硬膜下血肿扩大（图）。制定了先清除左侧硬膜下血肿再清除右侧帽状腱膜下血肿的手术方案。¹然而，发生了呼吸和心脏骤停，并伴有持续性低血压，血液检查显示急性凝血障碍和血小板减少，禁忌手术。他接受了保守治疗，并在创伤后 36 小时死亡。虽然罕见，但由于凝血障碍患者的颅内压迅速升高，可能会发生急性硬膜外血肿完全转变为帽状腱膜下血肿。