According to MSc.BSCKII Doan Thi Huyen, Department of Examination and Outpatient Treatment, Central Tropical Diseases Hospital, patient P.V.D (50 years old, Bac Ninh) was brought for examination after many episodes of loss of consciousness accompanied by short hand and foot convulsions, between episodes of almost normal activities. The family suspected "brain worms" and requested a blood test, but through careful examination of medical history, the doctor determined that these were generalized epilepsy episodes and it was necessary to find the cause of physical damage in the brain.
Notably, the patient had fallen and hit his head when he had a seizure about a month ago – an important detail suggesting a risk of chronic cerebrovascular hematoma. Acute MRI of the skull showed large subdural hematoma, causing a blocking effect and suppressing the middle of the brain, a condition that could lead to paralysis, coma or death if treated slowly.
The patient was then transferred for emergency neurosurgery to remove the hematoma and treatment with anti-epileptic drugs. After intervention, consciousness improved well, and no more seizures appeared.
Through this case, doctors recommend that seizures and loss of consciousness, even if short and fleeting, are also abnormal signs of the brain, and should not be subjective or only do tests based on speculation. When there is a fall or head impact, it is necessary to go for an early examination and perform imaging tests such as CT and MRI to promptly detect dangerous intracranial lesions and protect the patient's life.
