Bilateral acute-on-chronic subdural haematoma
An alcoholic patient with altered consciousness for 20 days.
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Bilateral mixed density subdural haematoma with hematocrit effect. The haematoma is also spreading into the falx and tentorium. Effacement of bilateral cortical sulci and buckling of the grey-white matter interface.
CT appearance of chronic subdural haemorrhage is variable. Generally they are hypodense crescentic collection on NECT unless complicated. Acute on chronic SDH may present as mixed density collection, loculated collection or gravity dependent layering of blood products.