Subdural haematoma and Duret haemorrhage

Case contributed by Dr Bruno Di Muzio

Presentation

Sudden onset of unresponsiveness. GCS 5.

Patient Data

Age: 81-year-old

CT Brain

Modality: CT

Large acute convexity subdural haematoma extending along the left cerebral hemisphere with significant mass effect over the brain parenchyma, which is characterised 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 haemorrhagic focus on the right side of the pons/pontomesencephalic junction in keeping with a Duret haemorrhage. 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 haematoma with cerebral herniations, midline shift, and Duret haemorrhage

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Case Information

rID: 46756
Case created: 15th Jul 2016
Last edited: 15th Jul 2016
Tag: rmh
Inclusion in quiz mode: Included

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