Hyperacute and subacute subdural hematoma

Case contributed by Ammar Haouimi

Presentation

Sudden onset of left hemiparesis with gradual loss of consciousness.

Patient Data

Age: 75 years
Gender: Male

The MRI sequences demonstrate:

  • right crescent-shaped hemispheric subdural hematoma (maximum thickness 25 mm), eliciting an iso-to high signal intensity to the cortical grey matter on T1, high signal on T2, FLAIR, and GE sequences, indicating a hyperacute subdural hematoma. A mass effect is noted on the midline structures with no significant subfalcine herniation
  • small left subdural hematoma (maximum thickness 6 mm) hyperintense to the cortical grey matter on T1, and FLAIR, and isointense on T2, in keeping with subacute subdural hematoma
  • age-related cerebral volume loss with small vessel ischemic disease

Case Discussion

MRI features of bilateral subdural hematoma, hyperacute on the right and subacute on the left.

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