Acute subdural hemorrhage

Case contributed by A.Prof Frank Gaillard

Presentation

Confusion

Patient Data

Age: 65
Gender: Male
CT

A dense subdural collection is demonstrated overlying the right cerebral convexity measuring up to 1 cm in maximal depth. There is also subdural blood seen tracking along the right tentorium as well as along the falx. No evidence of acute intraparenchymal hemorrhage. There is mild underlying mass effect characterized by sulcal effacement but no significant midline shift. No herniation.

No CT evidence of acute infarction. The ventricles and basal cisterns are preserved. Appearances within the posterior fossa are suspicious for mega cisterna magna or alternatively an arachnoid cyst.

Case Discussion

This case highlights the importance of using subdural windows on your PACS workstation in trauma as a thin acute subdural can be so hyperdense as to blend with the adjacent skull. Also note the appearance of the tentorium on axial images, representing thin layering blood over its surface. 

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Case information

rID: 30404
Published: 31st Aug 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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