Subacute subdural haematoma
Male patient in late 60's on medical ward, who is 'out of sorts'. No neurological examination findings given. No prior CT head.
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Large T1 hyperintense, T2 hypointense right sudural collection with marked effacement and displacement of the right lateral ventricle ( 'midline shift' ).
Subdural haematoma is one form of extra-axial collection.
It is typically identified on CT head, which is the first line investigation for concerns over intracranial haemorrhage and unspecified CNS symptomatology.
This MRI illustrates the ability of ageing blood on MRI, in this case the collection being subacute in nature.
In this case the subdural haematoma is causing severe mass effect, for which the patient proceeded promptly for surgical evacuation.
Imaging requesting after sound clinical assessment remains the most effective, satisfying and cost effective form of clinical medicine.