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Subdural hemorrhage: acute-on-chronic

Case contributed by Jeremy Jones
Diagnosis certain

Patient Data

Age: Elderly

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Right subdural hematoma with mixed density - the hyperdense (acute) component is seen inferiorly when the hypodense (chronic) component is seen superiorly. 

Case Discussion

CT scan through the brain of an elderly patient demonstrates a subdural hemorrhage with acute and chronic components. Note how the acute blood sinks inferiorly (hematocrit effect). A similar appearance can rarely be seen in acute hemorrhage in patients on anticoagulants, where the blood separates into serum and hematocrit rather than clotting. 

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