Subacute subdural haematoma
Subdural haematoma evacuation 4 weeks prior. Re-admitted with altered GCS.
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Right frontal and parietal burr holes.
Large right sided frontoparietal, almost exclusively isodense, subdural haematoma with a minor amount of acute blood in the inferior aspect of the collection.
Marked sulcal effacement and compression and shift of the right lateral ventricle with subfalcine herniation.
Subacute subdural haematomas are the most difficult to identify especially when small, as the blood is isodense to the brain parenchyma.
Ancillary signs of sulcal effacement and use to of manual windowing ( second set of CT images ) assist in delineation.