Post surgical extra-axial collection
Day 1 post resection of AVM ?bleed.
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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.
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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.