Received 11/08/2023 Review began 11/29/2023 Review ended 12/12/2023 Published 12/17/2023 © Copyright 2023 Zade et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Rehabilitation of Traumatic Acute Subdural Hematoma and Subarachnoid Hemorrhage: A Case Report Amisha P. Zade , Shruti S. Bhoge , Nikita H. Seth , Pratik Phansopkar 1. Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND Corresponding author: Amisha P. Zade, 23amishazade@gmail.com Abstract A head injury or cerebrovascular illness may be the cause of acute intracranial hemorrhage. Making a precise diagnosis is challenging since diagnostic imaging might be challenging in both situations. In this case report, an aneurysmal rupture related head injury resulted in an acute subdural hematoma (SHD) after the patient lost consciousness. A 54-year-old male was found in a state of unconsciousness on the ground and was brought to the nearest hospital. Computed tomography (CT) scan showed an oblique fracture involving the bilateral frontal and right parietal bones along with underlying SDH, subarachnoid hemorrhage (SAH), and hemorrhagic contusion along with midline shift. The case report highlights the rehabilitation journey of a patient with acute SDH and SAH. The patient can now sit independently and stand with minimal assistance. Vasospasm detection, prevention, and treatment need to be the norm at that time. This case demonstrates the effectiveness of a comprehensive rehabilitation approach in promoting mobility and independence for patients with traumatic brain injuries. Categories: Neurology, Neurosurgery, Physical Medicine & Rehabilitation Keywords: case report, physiotherapy, gait impairment, coordination exercises, balance exercises, balance, intra cranial pressure, relaxation techniques, mobility training, acute subdural hematoma Introduction In acute subdural hematoma (SDH), there is bleeding between the brain and its outermost covering, while subarachnoid hemorrhage (SAH) involves bleeding in the space around the brain. Severe and high-impact injuries usually cause acute SDH. Trauma, cerebral hypotension, and faulty coagulation are further potential causes. Through a combination of functional mobility activities, core stability exercises, balance, gait training, and relaxation exercises, the patient can achieve significant improvement in functional independence; however, numerous risk factors, including advanced age, alcohol consumption, certain medications (antiplatelet, anticoagulants), and, finally, a history of brain damage, can potentially exacerbate this problem [1]. There are comparable risk factors for aneurysmal development in cases of SAH caused by aneurysmal causes [2]. The most frequently noted risk factors include smoking, hypertension, and family history. Alcohol, sympathomimetic medications, and low estrogen levels are further risks. At the dura- arachnoid junction, there is a specialized layer of fibroblasts called the dural border cell layer. It is distinguished by flattened fibroblasts, extracellular gaps, little extracellular collagen, and few cell connections [3]. A tiny portion of instances may not be discovered during the first angiographic examinations, but they may be found after a follow-up angiography and placed in this category [4]. Guidelines on surgical treatment of traumatic SDH have been released by the Foundation for Brain Trauma [5]. Nevertheless, the proportion of SDH patients who can be selected for conservative therapy and the outcomes of these individuals are poorly comprehended. Aneurysmal SAH is an acute neurologic emergency [6]. To stop bleeding again, the aneurysm must be promptly and definitively treated by a craniotomy and clipping or endovascular intervention using coils and/or stents [7]. The study sought to identify risk variables linked to deteriorating and postponed surgery, as well as the percentage of patients who get conservative therapy initially and the percentage of patients who would deteriorate and need surgical evacuation [8]. Ruptures of an aneurysm can cause SAH, which makes up around 5% of all strokes [9]. Frailty in the elderly should be regularly assessed as it may result in increasing morbidity and mortality, opening the door to therapies in the areas of medicine, surgery, nutrition, cognitive function, and physical activity [8]. This study aims to improve understanding of aneurysmal SAH, a rare and serious illness that has a significant risk of severe morbidity and death, in terms of both diagnosis and therapy [10]. This case demonstrates the effectiveness of a comprehensive rehabilitation approach in promoting mobility and independence for patients with traumatic brain injuries. Case Presentation A 59-year-old male, working as a driver, was brought to Acharya Vinoba Bhave Rural Hospital (AVBRH) in an unconscious state. The patient was alright till October 6, 2023; he was found unconscious on the ground and was brought to the nearest hospital where his Glasgow Coma Scale score was found to be 9. The patient was 1 1 1 1 Open Access Case Report DOI: 10.7759/cureus.50660 How to cite this article Zade A P, Bhoge S S, Seth N H, et al. (December 17, 2023) Rehabilitation of Traumatic Acute Subdural Hematoma and Subarachnoid Hemorrhage: A Case Report. Cureus 15(12): e50660. DOI 10.7759/cureus.50660