Subdural Hematoma


Subdural haematoma



  • 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


  • Acute: nonadherent gelatinous blood. Red blood cells
  • Chronic: fluid adherent to meninges, fibrous tissue if old. Microscopically: macrophages, capillaries, hemosiderin or fibrous tissue


  • If Acute Surgical: craniotomy & evacuation under direct vision
  • If subacute or chronic: consider burr-hole drainage or a case by case basis

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