Subacute subdural hematoma

Case contributed by Abiola Ayodele


Blurred vision, dizziness, poor sleep, vomiting, and fainting attacks. The patient was involved in a road traffic accident 2 weeks prior to the presentation at the hospital.

Patient Data

Age: 40 years
Gender: Male

An isodense subdural collection with a maximum thickness of 17mm in the convexity of the left frontoparietal lobe. There is a significant mass effect evidenced by effacement of the ipsilateral sulci and gyri, left lateral ventricle as well as midline shift to the right. 

Case Discussion

Subdural hematoma is a collection of blood accumulating in the subdural space, the potential space between the dura and arachnoid mater of the meninges. It occurs in any age group, and it usually follows head trauma.  CT scans are usually sufficient to make the diagnosis. Subacute subdural hematoma appears isodense to grey matter, making it difficult to be differentiated from the brain parenchyma. Following contrast administration, the cortex enhances, making it easier to differentiate the brain parenchyma from the collection as demonstrated in this case. The patient subsequently had a burr hole for drainage.

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