Chronic subdural hematomas

Case contributed by Dr Euan Zhang

Presentation

Altered level of consciousness. Patient was diagnosed with bilateral chronic subdural hematomas on CT and underwent a left frontal burr-hole craniostomy.

Patient Data

Age: 90 years
Gender: Male
CT

There are moderate sized bilateral chronic subdural hematomas exerting a mild degree of underlying mass effect. There is a small subdural component on the right. There are admixed strands of fibrous tissue or trace acute hemorrhage in the left collection. There is no midline shift or other evidence for brain herniation. There has been a left burr-hole craniostomy for drainage.

CT

1 month later

One-month follow up shows development of an expanded subacute component of the subdural hematoma on the right, indicative of rebleed. The left collection has degressed in volume. The left drainage tube has been removed.

Case Discussion

Case of subacute on chronic subdural hemorrhage. Due to the patient's underlying atrophy, there was only a mild degree of mass effect, and certainly no brain herniation. The patient did not complain of new symptoms on follow up, even with expansion of his right subdural collection. The patient and the surgeon decided on conservative management and close observation for the time being.

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Case information

rID: 66577
Published: 26th Feb 2019
Last edited: 28th Feb 2019
Inclusion in quiz mode: Excluded

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