Acute on chronic subdural haematoma
Acute onset of headache, confusion and right hemiplegia ? CVA or haemorrhage
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Large fluid collection (chronic subdural haematoma) overlying the left convexity with marked mass effect. Note the sediment of higher density indicating acute haemorrhage into the chronic collection. Note also the high density membranes in the chronic subdural anteriorly highlighted by the presence of acute blood around them.
The key to differentiating chronic subdural haematoma from hygroma is the presence of membranes (commonly seen at autopsy but less well seen on CT scanning)