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The clinical presentation and surgical management of an interhemispheric subdural hematoma, a rare entity, is presented and the literature reviewed. Either hemiparesis, worse in the lower than the upper extremity, or lower extremity monoparesis is characteristic of this lesion. Computerized tomography (CT) is the preferred diagnostic procedure. An interhemispheric hematoma, either acute or chronic, is best treated by osteoplastic craniotomy. Specific anatomical considerations, clinical features, and the recommended surgical technique is described.
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