Subacute subdural haematoma

Case contributed by Dr Ian Bickle

Presentation

Male patient in late 60's on medical ward, who is 'out of sorts'. No neurological examination findings given. No prior CT head.

Patient Data

Age: 69
Gender: Male
MRI

Large T1 hyperintense, T2 hypointense right sudural collection with marked effacement and displacement of the right lateral ventricle ( 'midline shift' ).

Case Discussion

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.

 

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Case information

rID: 32123
Case created: 15th Nov 2014
Last edited: 14th Sep 2015
Inclusion in quiz mode: Included

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