Acute on chronic subdural hemorrhage
Dull occipital headache for a weak, known thrombophilia and myelodysplastic syndrome. Ischemia? IC bleeding?
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- 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
Findings are in line with acute subdural hemorrhage sustained onto either a chronic subdural bleeding or hygroma.