Presentation
An elderly patient with recent decline in memory. Fell out of bed approximately one week earlier. No loss of consciousness. Alert, asymptomatic, no focal neurological deficit.
Patient Data
Bilateral widened subdural spaces with low-density collections (best appreciated near the vertex) indicative of chronic hygromas.
Note that despite being a non-contrast study the cortical veins can be discerned traversing medially to the collections (best seen in the coronal plane, also check annotated key images), thus we can conclude that the cortical vein sign is negative.
Signs of age-related cortical atrophy.
The cortical veins (green arrows) can be discerned traversing medially to the collections. thus we can conclude that the cortical vein sign is negative.
Case Discussion
The main differential diagnosis is chronic subdural hematoma
A subdural hygroma is an asymptomatic finding on CT studies, but in some cases may increase in size (flap-valve mechanism or bleeding) and causes a mass effect.