Synonyms:
Subdural haematoma
Diagnosis:
CT:
- Crescent shaped, diffuse covering a large part of the hemisphere
- Can be biconvex in shape
- Can be of mixed density: e.g. Fluid-fluid level
- Cross suture lines but not the midline
- Variation with time:
- Acute, hyperdense, homogenous
- Middle, isodense with brain
- Chronic: hypodense
- Acute on chronic: heterogenous, fluid-fluid levels
Pathology:
- Acute: nonadherent gelatinous blood. Red blood cells
- Chronic: fluid adherent to meninges, fibrous tissue if old. Microscopically: macrophages, capillaries, hemosiderin or fibrous tissue
Treatment:
- If Acute Surgical: craniotomy & evacuation under direct vision
- If subacute or chronic: consider burr-hole drainage or a case by case basis