Artifact mimicking bilateral acute subdural hematomas

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Motor vehicle accident with boggy swelling over occiput. Patient confused and disorientated.

Patient Data

Age: 17 years
Gender: Female

Scalp hematoma over the occiput at the vertex responsible for the boggy swelling. No skull fracture.

Hyperdense crescent overlying the right and left parietal lobes.

The bone window and 3D VR clearly identify patient movement with bony overlap responsible for the hyperdense crescents, explaining the apparent bilateral subdural hematomas posteriorly.

Case Discussion

This example demonstrates that artefacts, e.g. due to patient movement, can mimic subdural hematomas, illustrating the importance of reviewing bone windows and 3D reconstructions.

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