Subacute subdural hematoma (subtle)

Case contributed by Dr Ian Bickle

Presentation

Young female in haematology ward. Complains of headache. Apyrexic. Severe thrombocytopenia.

Patient Data

Age: 30 years
Gender: Female

Thin left frontal subdural collection, with a maximum depth of 5mm.  Iso to hypoattenuating with no high attenuation component.

No significant mass effect.

Normal mastoids and paranasal sinuses.

CT

Patient recalled from ward for contrast scan

No enhancement of the thin left-sided subdural collection.

Case Discussion

Case offered to illustrate a relatively subtle subdural collection - when small and the attenuation is close to that of the normal brain, identification is more difficult, especially with no mass effect.

The differential would be; empyema, subacute subdural hematoma or a hygroma.

The lack of enhancement, attenuation of the subdural content and the clinical history would suggest a subacute subdural to be most likely.

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Case information

rID: 59593
Published: 16th Apr 2018
Last edited: 16th Apr 2018
Inclusion in quiz mode: Included

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