Presentation
Acute onset of headache, confusion and right hemiplegia ? CVA or hemorrhage
Patient Data
Age: 85
Gender: Male
From the case:
Acute on chronic subdural hematoma
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Large fluid collection (chronic subdural hematoma) overlying the left convexity with marked mass effect. Note the sediment of higher density indicating acute hemorrhage into the chronic collection. Note also the high density membranes in the chronic subdural anteriorly highlighted by the presence of acute blood around them.
Case Discussion
The key to differentiating chronic subdural hematoma from hygroma is the presence of membranes (commonly seen at autopsy but less well seen on CT scanning)