Presentation
Elderly male. Several days of altered behaviour and less communicable.
Patient Data
Bilateral near isodense moderate sized subdural haematomas, marginally larger on the left.
Layering of blood of variable age, best appreciated anteriorly in the subdural haematomas.
Minor midline shift to the right.
Evacuation procedured undertaken.
Bilateral parietal burr holes.
Extensive pneumocephalus in the subdural space with the Mount Fuji sign evident at the vertex.
Bilateral residual subdural haematomas.
Case Discussion
Couple of learning points from these interval scans of the brain.
1. Subacute subdural haematomas are isodense with the brain. So when thin may be hard to appreciate on normal 'brain windows'.
2. Bilateral subdural collections can result in minimal midline shift
3. The follow up scan is a decent example of the Mount Fuji sign due to pneumocephalus.