Acute on chronic subdural hemorrhage

Case contributed by Bálint Botz


Dull occipital headache for a weak, known thrombophilia and myelodysplastic syndrome. Ischemia? IC bleeding?

Patient Data

Age: 80 years
Gender: Male
  • Large, hetegeneous left fronto-parietal subdural collection with resultant compression of the lateral ventricle and midline shift with subfalcine herniation
  • Note dilatation of the contralateral lateral ventricle best observed in the temporal horn
  • Partial descending transtentorial herniation of the uncus, best appreciated in the coronal plane (see stack key image)
  • Small right parafalcine hyperdense subdural collection

Case Discussion

Findings are in line with acute subdural hemorrhage sustained onto either a chronic subdural bleeding or hygroma. 

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