Presentation
Confusion/altered mental status x1 day. Difficulty remembering timeline of events.
Patient Data
There is a mixed density subdural hematoma along the right cerebral convexity, which causes significant sulcal and right lateral ventricle effacement. There is a leftward midline shift. The basal cisterns are effaced.
The patient is status post right frontal subdural drain placement with a subsequent decrease in size of the mixed density right holohemispheric subdural hematoma.
There is decreased leftward midline shift compared to the prior exam. There is essentially unchanged effacement of the right lateral ventricle, with a mild decrease in effacement of the third ventricle.
Image of the type of drain used in this case.
Image obtained from Safain et al. 2012.1
Case Discussion
This is a subdural drain, specifically a Subdural Evacuating Port SystemTM (SEPS; Medtronic, Minnesota, USA). After receiving the subdural drain, the patient continued to improve clinically. Repeat CTs revealed a progressive decrease of the subdural hematoma.