Subdural hemorrhage (SDH) - acute

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Slipped and hit head on side-walk. Now decreased conscious level (GCS 6).

Patient Data

Age: 85 years
Gender: Male

CT brain

ct

There is a hyperdense right sided extraxial collection measuring up to 20 mm in maximal depth overlying the right cerebral convexity. There is mass effect with approximately 15 mm of midline shift towards the left measured at the level of the third ventricle, with early uncal herniation and obstructive hydrocephalus of the left lateral ventricle.

Hyper-density in the right maxillary antrum suggests further blood, associated with a maxillary fracture and zygomatic arch fracture (confirmed on bone window, not shown). 

Case Discussion

This case illustrates typical appearances of a large acute subdural hemorrhage (SDH). 

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