Bilateral acute-on-chronic subdural haematomas

Case contributed by Dr Henry Knipe

Presentation

Unwitnessed fall last night with head strike

Patient Data

Age: 95
Gender: Male

There are large bilateral acute on chronic subdural haematomas. Midline shift to the left at the level of the septum pellucidum. There is marked mass-effect with sulcal effacement but there is no uncal or downward transtentorial herniation. Overlying the left frontal pole is a hyperdense collection, which does not cross suture lines and is separate to the subdural and presumably extra dural in nature.

Case Discussion

The mixed nature of the subdural collections with dependent hyperdense layering is a good sign of the acute on chronic nature. The left frontal collection is probably epidural in location but alternatively could be a loculated subdural haematoma. 

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Case information

rID: 40237
Case created: 13th Oct 2015
Last edited: 24th Aug 2017
Inclusion in quiz mode: Included

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