Presentation
Right hemiparesis.
Patient Data
Age: 70 years
Gender: Male
From the case:
Subacute subdural hematoma
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Large left-sided frontoparietal subdural collection (maximum thickness = 25 mm) , isodense to the cortical grey matter. Marked effacement of the cortical sulci with a mass effect of the midline structures and subfalcine herniation.
Case Discussion
Subdural hematomas are difficult to identify in the subacute phase because the collection of blood is isodense to the adjacent cortex.
Some indirect signs will help to identify the presence of subdural collection including:
- CSF-filled sulci do not reach the skull but rather fade out into the subdural
- mass-effect including sulcal effacement (distortion) and midline shift
- apparent thickening of the cortex
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