Bilateral acute-on-chronic subdural hematomas
Unwitnessed fall last night with head strike
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There are large bilateral acute on chronic subdural hematomas. 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.
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 hematoma.