Acute on chronic subdural hematoma

Case contributed by Dr Heba Abdelmonem


Right sided weakness.

Patient Data

Age: 90 years
Gender: Female

Left frontoparietal extra-axial hemorrhage with horizontal sedimentation level. Although it has an elliptical shape, the finding is in keeping with acute on chronic subdural hematoma which are much more common in this age group. Mass effect in the form of effaced related sulci, as well as few millimeters of shifting of the midline, is demonstrated as well.

Case Discussion

The absence of a history of trauma, the absence of a skull fracture, the advanced age of this patient and the fact that it crosses the coronal suture, make the possibility of this being an epidural hematoma very unlikely despite the biconvex appearance of the lesion in our case. Extradural hematomas in infants and geriatric may not manifest in a serious way due to the relatively small size of the brain and the prominent extra-axial CSF spaces.



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Case information

rID: 52743
Published: 22nd Apr 2017
Last edited: 14th May 2020
Inclusion in quiz mode: Included

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