Subdural haematoma (SDH) age

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Subdural haematoma (SDH) age

  • This patient with a subdural haematoma had three CT scans - one at the time of injury, one at 1 month and another at 2 months post injury
  • Initially the subdural haematoma is higher in density or 'hyperdense' (whiter) when compared to the adjacent brain cortex
  • At 1 month the collection is difficult to see because it is identical in density or 'isodense' to the adjacent brain cortex
  • At 2 months the subdural is 'hypodense' (darker) when compared to the adjacent brain cortex

Clinical information

  • Memory loss following a fall

Chronic SDH with rebleeding

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Chronic SDH with rebleeding

  • Subdural haematomas may be bilateral - as in this image
  • The low density material in these subdural collections is due to a chronic subdural haematoma
  • The higher density layered material is due to more recent haemorrhage

Clinical information

  • Traumatic bilateral subdural haematomas seen on a previous CT several weeks earlier
  • Recent increased drowsiness
  • Note: Chronic subdurals can present without a clear history of trauma

Hyperacute subdural haematoma

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Hyperacute subdural haematoma

  • This crescent-shaped subdural haematoma contains mixed high density and low density material
  • The dense (white) material represents recently clotted blood
  • The less dense blood (grey) is not due to a chronic haematoma, it is hyperacute blood which has not yet had time to clot
  • (The bone windows did not demonstrate a skull fracture)

Clinical information

  • Alcoholic with poor liver function and deranged clotting
  • Reduced consciousness following minor head injury