Subacute subdural haematoma
Elderly patient. Left sided weakness. No history of fall. Clinically assumed stroke.
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Near isodense large left sided subdural haematoma with ventricular effacement and midline shift. Thin, more hyperdense parafalcine haematoma close to the vertex.
Background atrophy change.
Note how the collection follows the dural reflections, up against the falx, as well as crosses the coronal suture; all features that this is a subdural rather than extra-dural collection.
Subdural haematomas are one of the potential 'stroke mimics' in the elderly.
This isodense haematoma is likely 7 days or more in age, with the atrophic brain 'accomodating' the haematoma prior to presentation.