A 52-years-old patient with unremarkable medical history, was admitted to our hospital after a severe brain injury secondary to a fall from 3.5 m. On admission, he was unconscious, Glasgow coma scale was 7 with a right anisocoria. The CT scan showed a right subdural hematoma with a midline shift of 11mm and a contralateral fracture (Figure 1). He underwent a craniotomy with hematoma evacuation, surgery was uneventful.

The routine postoperative CT scan showed a large left epidural hematoma (Figure 2). A second operation was done immediately and the patient was transferred to ICU.

Only few cases were reported in literature, of an epidural hematoma contralateral to the evacuation of an SDH [1]. It’s a devastating complication especially if the diagnosis is delayed [2]. There aren’t specifics clinical characteristics of contralateral EDH after evacuation of SDH. Various hypotheses have been proposed to explain this complication but it’s not clear [3]. Immediate postoperative CT scan is very important especially if we had a contralateral skull fracture, brain swelling or high intracerebral pressure after surgery.