Subdural hemorrhage - CTA spot sign

Case contributed by Assoc Prof Frank Gaillard

Presentation

Head injury

CT of the brain demonstrates a large acute subdural hemorrhage with associated extensive cerebral contusions and a large scalp hematoma on the left, in keeping with a coup-contrecoup injury pattern. 

CTA demonstrates a globular blush of contrast (spot sign) representing active extravasation of blood into the subdural hemorrhage.

Case Discussion

It is always important to remember that CT is a snapshot of a potentially dynamic process, and the size of a hemorrhage at the time of the scan does not mean that it will not continue to enlarge. Presence of a spot sign in parenchymal hemorrhages has been well described, however, identical findings will be seen wherever active bleeding occurs. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.