Chronic subdural hematoma - importance of dural membranes

Case contributed by Dr Chris O'Donnell

Presentation

Past history of obstructive hydrocephalus treated with shunting. Now headache and lethargy.

Patient Data

Age: 75 years
Gender: Male

Thin slightly hyperdense membranes paralleling the skull vault and cerebrum are a feature of chronic subdural hematomas.

A section of dura from the vertex of the skull removed at autopsy showing normal dura to the right of the sagittal sinus and chronic hematoma on the left containing a prominent membrane.

Case Discussion

Thin slightly hyperdense membranes paralleling the skull vault and cerebrum are a feature of chronic subdural hematomas, indeed pathologists rely on the detection of these membranes at autopsy to confirm chronic blood consistent with hygroma. The same can be used on CT or MRI, i.e. if extra-axial membranes are detected on imaging then there are definitely chronic subdural blood collections rather than just prominent CSF spaces or bland hygromas. In this case, they are probably the result of "overshunting".

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Case information

rID: 19751
Published: 9th Oct 2012
Last edited: 31st May 2019
Inclusion in quiz mode: Excluded

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