Presentation
Day 1 post resection of AVM ?bleed.
Patient Data
Right frontoparietal craniotomy noted. Underlying the the flap is an extra- axial collection measuring up to 6.5mm that is high-density (*95HU) and most likely represents acute blood. At the inferior aspect of the surgical resection cavity is some high-density material measuring 25 x 13mm, which represents parenchymal hemorrhage. Mass effect evidence by right cortical sulcal effacement and right-to-left midline shift of 3mm, which is stable. Ventricular size is unchanged. Right frontoparietal subcutaneous hematoma and gas.
Case Discussion
This is an excellent example of the need to review subdural windows on all brain imaging, especially post neurosurgery. The extra-axial collection is hyperdense at 95HU and is indistinguishable from bone on the brain windows but is easily seen on the subdural windows.
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