Subdural hygroma with secondary hemorrhage

Case contributed by A.Prof Frank Gaillard

Presentation

Head trauma

Patient Data

Age: 65 years
CT

CT 5 months before trauma

Single CT image demonstrating a normal, albeit volume depleted, brain. 

CT

CT day of trauma

CT acquired within 24 hours of head trauma demonstrates a CSF intensity collection over the left hemisphere. A small amount of traumatic subarachnoid blood was also present on the right (not shown). 

CT

CT day 1 post trauma

The left sided subdural collection is enlarging but remains CSF density. A smaller right sided hygroma is also developing. 

CT

CT day 5 post trauma

There has been further enlargement of the subdural hygromas. A small amount of intraventricular blood (redistribution of the subarachnoid blood) is also seen. 

CT

CT day 23 post trauma

The right sided hygroma has resolved and the left hygroma has reduced in size. 

CT

CT day 62 post trauma

The patient is readmitted with decreased conscious state. An acute hemorrhage is now seen admixed with the hygroma on the left. Note how the CSF in the sulci is not involved (this blood is subdural not subarachnoid). 

Case Discussion

This case illustrates the development of subdural hygromas (CSF) post trauma, later complicated by a subdural hemorrhage. Often these hemorrhages are referred to as 'acute on chronic' although no prior hemorrhage was ever present. 

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Case information

rID: 55419
Published: 5th Sep 2017
Last edited: 5th Sep 2017
Inclusion in quiz mode: Excluded

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