Bilateral subdural hygroma

Case contributed by Bálint Botz
Diagnosis certain


Fell out of bed approximately one hour earlier. No loss of consciousness. Alert, asymptomatic, no focal neurological deficit.

Patient Data

Age: 85 years
Gender: Male
  • Bilateral widened subdural space with low density collections (best appreciated near the vertex) indicative of chronic hygromas. 
  • Note that despite being noncontrast study the cortical veins can be discerned traversing medially to the collections (best seen in the axial and coronal plane, also check annotated key image), thus we can conclude that the cortical vein sign is negative. 
  • Signs of age related cortical atrophy and chronic small vessel ischemia. 
  • No sign of acute trauma, or bony injury (bone kernel recons not shown).
Annotated image

Cortical veins (highlighted) traversing medially to the collection, confirming its subdural location. 

Case Discussion

Typical appearance of incidentally encountered chronic subdural hygroma.

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