Acute subdural haemorrhage
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Hyperdense cresenteric haematoma, extending across suture lines, in keeping with an acute subdural haemorrhage. Right-to-left midline shift with subfalcine herniation.
Subfalcine herniation, the most common intracranial herniation pattern, is characterised by displacement of the brain beneath the free edge of the falx cerebri due to raised intracranial pressure. Unilateral mass effect from pathology in the frontal, parietal or temporal region, such as haemorrhage or tumour, causes displacement of the brain away from the mass. Complications are contralateral hydrocephalus (due to obstruction of the foramen of Monro) and anterior cerebral artery territory infarct (due to compression of ACA branches).
Case credit: Dr Donna D'Souza.
- Osborn A, Tong K. Handbook of Neuroradiology: Brain and Skull, 2nd edition. Mosby 1996