Where is this collection?
Although not uniformly "crescentic" with a bulge at the level of the lateral ventricles, it is not bound by bony sutures and fills the right hemicranium so it is a subdural haemorrhage.
What are the significant findings in this scan?
There is a huge extra-axial mixed density collection on the right side. This is causing significant mass effect, with midline shift, subfalcine hernation (right sided structures "squeezed" under the rigid border inside the skull) and dilatation of the left lateral ventricle.
Why is the collection mixed in its density?
There a couple of reasons in this case - we see mixed density when there is active bleeding and also in anti-coagulated patients.
What methods are available to treat acute subdural haemorrhages?
Initial resuscitation, systematic assessment and support is required. Monitoring of neurological signs is essential in case of progression. Early discussion with neurosurgical services for consideration of evacuation or ventricular drain insertion. ICU opinion can also be recommended. Conservative measures in this case included warfarin reversal with vitamin K and clotting factors.
Non-contrast axial CT head: right sided subdural mixed density collection with midline shift, subfalcine herniation and contralateral ventricular dilatation.