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Clinical Notes
February 8, 1964

Traumatic Encephalopathy vs Possible Subdural Hematoma

JAMA. 1964;187(6):456-458. doi:10.1001/jama.1964.03060190072024

SINCE THE PAPERS of Trotter,1 Putnam, and Cushing2 on chronic subdural hematoma were published, neurologists and neurosurgeons have been well aware of this entity. Its protean manifestations make its inclusion in the differential diagnosis of encephalopathy practically mandatory, especially when there is a history of trauma.

In the following two cases, subdural hematoma was strongly suspected, but the final diagnosis in both was encephalopathy of unknown cause associated with trauma.

Report of Cases 

Case 1.—  Approximately five weeks before admission, a 73-year-old man was struck by a car and rendered unconscious. He was hospitalized elsewhere, his condition improved, and he was discharged after six days. During the ensuing weeks, he was more or less lethargic and withdrawn. Five days prior to hospitalization he began to have difficulty in walking and talking. He was disoriented to time, had a poor memory, and a mild expressive aphasia. The face-hand test

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