Chronic subdural haematoma: importance of "membranes" on CT

Case contributed by Dr Chris O'Donnell

Presentation

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

Patient Data

Age: 75
Gender: Male

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

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 haematoma 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 haematomas, 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
Case created: 9th Oct 2012
Last edited: 28th Nov 2016
Inclusion in quiz mode: Excluded

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