Subdural hemorrhage - acute

Case contributed by Frank Gaillard

Patient Data

Age: Adult
ct

Hyperdense cresenteric hematoma, extending across suture lines, in keeping with an acute subdural hemorrhage. Right-to-left midline shift with subfalcine herniation. 

Case Discussion

Subfalcine herniation, the most common intracranial herniation pattern, is characterized by displacement of the brain beneath the free edge of the falx cerebri due to raised intracranial pressure. Unilateral mass effect from pathology in the frontal, parietal or temporal region, such as hemorrhage or tumor, causes displacement of the brain away from the mass. Complications are contralateral hydrocephalus (due to obstruction of the foramen of Monro) and anterior cerebral artery territory infarct (due to compression of ACA branches).

Case credit: Dr Donna D'Souza.

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