Case 12 - Isodense Subdural Hematoma

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Report

Dr. Yousem has provided the following report as a sample report for your reference. It does not match the case reviewed in the video.

EXAM: CT head/brain without contrast

INDICATION: Follow-up evaluation of subdural hematomas.

TECHNIQUE: Axial noncontrast CT images of head/brain. Sagittal coronal reformats were performed.

COMPARISON: CT head/brain without contrast 8/3/2018

FINDINGS:

Right cerebral convexity mixed density subdural hematoma is not significant change since the prior study with greatest width of approximately 2.1 cm seen on the coronal reformatted projection. Degree of mass effect resulting in approximately 1.1 cm leftward midline shift at the level of the septum pellucidum as well as effacement of the subjacent cortical sulci and right lateral ventricle and right uncal herniation or impending herniation is also unchanged since prior study.

The smaller left cerebral convexity subdural hematoma is also unchanged since prior study with greatest width of approximately 5 mm along the left frontoparietal convexity. Degree of local mass effect with effacement of subjacent cortical sulci is unchanged. Unchanged hyperdense blood product tracking within the anterior falx.

No new intracranial hemorrhage or new extra-axial collections. Gray-white matter distinction is preserved. Scattered focal periventricular and subcortical white matter hypoattenuations, nonspecific but likely related to chronic microvascular ischemic changes. The orbital structures are unremarkable. The bony calvarium is intact.

IMPRESSION:

Unchanged CT appearance of right greater than left cerebral convexity mixed density subdural hematomas with stable degree of leftward midline shift the prior study of 8/3/2018 2336 hours. No new intracranial hemorrhage or extra-axial collections are identified.

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Introduction

Introduction to the Emergency Brain Imaging Course

Clinical Scenario 1

New Neurologic Deficit

CLINICAL SCENARIO 2

Head Trauma Introduction

CLINICAL SCENARIO 3

Worst Headache of Life

CLINICAL SCENARIO 4

Found Down

CLINICAL SCENARIO 5

Fever and Seizure

CLINICAL SCENARIO 6

S/P, VPS, New Lethargy

Case 12 - Isodense Subdural Hematoma