What is the diagnosis?
Very large right sided subdural haemorrhage.
Between what layers does a subdural haematoma accumulate?
The subdural space is a potential space between the inner layer of the dura mater and the arachnoid mater (superficial to the subarachnoid space).
True or false: subdural haematomas are not limited by the sutures of the skull?
True. Extradural haematomas are limited by the sutures whereas subdural hematomas will follow the inner contour of the dural reflections.
Can you identify the midbrain? What is occurring at this level?
The midbrain is pushed to the left by significant uncal herniation.
A very large acute subdural haemorrhage is present with marked midline shift and right uncal herniation. The left temporal horn is dilated in keeping with obstruction to the outflow of the left lateral ventricle.