Subdural hematoma after open-heart surgery.

Four cases are described of acute subdural hematoma that occurred after valve replacement in patients receiving anticoagulant therapy. All four patients experienced rapid deterioration of consciousness or neurological dysfunction, to varying degrees, between two and 42 days after valve replacement; emergency brain computed tomography scanning demonstrated the presence of subdural hematoma. The neurological problems were completely resolved by removal and drainage of the hematoma in three patients, while conservative management was performed with no aggravation of neurological symptoms in the fourth patient.