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Subdural hematoma and Duret hemorrhage

Case contributed by Dr Bruno Di Muzio

Presentation

Sudden onset of unresponsiveness. GCS 5.

Patient Data

Age: 80 years
CT

CT Brain

Large acute convexity subdural hematoma extending along the left cerebral hemisphere with significant mass effect over the brain parenchyma, which is characterized by sulcal effacement, significant rightward midline shift (2.5 cm), and subfalcine and uncal herniation. Third and lateral ventricles are compressed and distorted with dilatation of the right temporal horn in keeping with hydrocephalus. Small amount of intraventricular blood in the right temporal horn. There is a hemorrhagic focus on the right side of the pons/pontomesencephalic junction in keeping with a Duret hemorrhage. Grey-white matter differentiation is preserved. No evidence of acute infarct. Imaged orbits, paranasal sinuses, and calvarium are unremarkable.

Case Discussion

This case demonstrates an extensive subdural hematoma with cerebral herniations, midline shift, and Duret hemorrhage

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Case information

rID: 46756
Published: 15th Jul 2016
Last edited: 5th Dec 2020
Tag: rmh
Inclusion in quiz mode: Included

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