Acute subdural hematoma - use of CT windows

Case contributed by Dr Ian Bickle


Diabetic amputee in a RTA one week previously. Altered sensorium.

Patient Data

Age: 65
Gender: Female

Thin right parietal acute subdural hematoma, causing sulcal effacement, but no mid line shift. The blood extends over the right side of the tentorium.

Thin right anterior parafalcine subdural hematoma.

Small amount of subarachnoid blood in the right parietal lobe close to the cerebral convexity.

No skull vault or fracture.

Case Discussion

An example of the value of thorough assesment of CT on both the routine window settings, but also manual review.

It is particularly important to manually window (as shown in second set of images) to remove the 'glare' from the bony skull on the brain window settings.   Any thin amount of acute subdural blood is then more easily identifiable.

The sulcal effacement from the mass effect is visible on the routine brain windows, but identification is so much easier with the manual windowing.

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Case information

rID: 45541
Published: 30th May 2016
Last edited: 15th Dec 2019
Inclusion in quiz mode: Included

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