Subdural hematoma

Case contributed by Baqar Hasan


Headache and loss of consciousness in an hypertensive patient.

Patient Data

Age: 60 years
Gender: Male

Plain axial images of CT scan, plain brain show a large, well-defined extra-axial, subdural collection along right cerebral hemisphere having both blood and fluid densities within it. It is causing mass effect, contralateral midline shift and possible sub falcine brain herniation. Adjacent brain parenchyma is compressed. 

Case Discussion

A mixed attenuation collection having fluid and blood densities seen along the right cerebral convexity in subdural space. It is not forming any definite fluid-fluid or blood-fluid level. Findings favor acute active/ongoing subdural hematoma. If any fluid blood level seen, then likely possibility of patient having low hematocrit or there is clot retraction. In case of acute on chronic stage, previous imaging or CECT scan is suggested to look for marginal membranous enhancement 

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