IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Bilateral subacute hematomas: pre and post operative

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Elderly male. Several days of altered behavior and less communicable.

Patient Data

Age: 80
Gender: Male

Bilateral near isodense moderate sized subdural hematomas, marginally larger on the left.

Layering of blood of variable age, best appreciated anteriorly in the subdural hematomas.

Minor midline shift to the right.

 

Evacuation procedured...

ct

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 hematomas.

Case Discussion

Couple of learning points from these interval scans of the brain.

1.  Subacute subdural hematomas 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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.