Acute subdural hematoma
Presentation
Pedestrian hit by car. Decreased consious state.
Patient Data
CT brain
An 11 mm left frontal subdural hematoma effaces the cortical sulci and results in 2 mm of subfalcine herniation. A smaller subdural hematoma in the left anterior temporal fossa measures 7 mm.
Right temporal lobe hemorrhagic contusion is associated with sulcal subarachnoid blood and a thin (2 mm) subdural hematoma.
No intraventricular blood. No transtentorial or tonsillar herniation. Grey white matter differentiation is preserved, with no evidence of acute ischemia.
Case Discussion
In young patients acute subdural hematomas are usually seen in the setting of significant head trauma, usually with associated hemorrhagic contusions.