Huntington’s disease complicated by traumatic subarachnoid bleeding and subdural hematoma

Though Huntington’s disease (HD) is frequently complicated by falls and consecutive traumatic brain injury (TBI) with subdural hematoma (SDH), traumatic subarachnoid bleeding (SAB) has not been reported as a complication of HD. A 67yo female with HD due to a CAG-repeat expansion of 43 repeats, diagnosed 18 months earlier, was admitted after a fall with a Glasgow-Coma Scale (GCS) score of 3. Cerebral CT on admission revealed bilateral SDH and SAB. No aneurysm could be detected on conventional angiography. After extubation, she was non-responsive to verbal requests and typical choreatic movement recurred. Tiaprid, olanzapine, and tetrabenazine were of limited effect. This case shows that falls in HD may not only cause SDH but rarely traumatic SAB. TBI in HD may worsen the phenotype and may increase the risk of a poor outcome