Subdural hematoma and electroconvulsive therapy: A case report and review of the literature.

BACKGROUND AND CASE PRESENTATION: Electroconvulsive therapy (ECT) is a common therapeutic procedure in psychiatry associated with a low rate of complications. We report a rare case of subdural hematoma (SDH) associated with ECT.

CLINICAL PRESENTATION: a 64 year old woman, with a medical history of persistent depression which required ECT six years previously, underwent ECT following a new acute episode. After four ECT sessions, a left hemiparesis occurred. Brain CT scan revealed a right SDH. The patient underwent surgery and fully recovered three months after the drainage of the hematoma. We conducted a review of all cases in which SDH was associated to ECT.

CONCLUSION

Early stage brain imaging is indispensable prior to starting ECT. Moreover, a previous medical history of SDH may not be a contraindication to ECT. In these situations, a clinical and radiological follow-up by both the psychiatrist and the neurosurgeon during all the ECT sessions is highly recommended.