Acute subdural hemorrhage - on warfarin

Case contributed by Derek Smith

Presentation

Fall with head injury and confusion. Warfarinised for metallic heart valve.

Patient Data

Age: 90 years
Gender: Male

Non-contrast axial CT head: right sided subdural mixed density collection with midline shift, subfalcine herniation and contralateral ventricular dilatation.

Case Discussion

Acute subdural hemorrhage with significant mass effect.

Initially this patient's Glasgow Coma Score (GCS) was 13 (E4V4M6) but shortly after going into the scanner GCS dropped to 7 (E1V2M4). This case was managed conservatively.

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