Findings
- Acute left cerebral convexity subdural hematoma measuring up to 2 cm in thickness with areas of intermixed hypoattenuation
- Associated left greater than right cerebral sulcal effacement with left to right midline shift measuring 10 mm at the foramen of Monro and medialization of the left temporal uncus with slight effacement of the suprasellar cistern
- Partial effacement of the left lateral ventricle
- Dilation of the right lateral ventricle
- Encephalomalacia in the right frontal lobe
- Patchy subcortical and periventricular white matter hypoattenuation compatible with sequela of chronic microvascular ischemic disease
- Calcified intracranial atherosclerosis
- Bilateral lens replacements
- Sequela of prior right frontal craniotomy
Diagnosis
Mixed attenuation acute subdural hematoma
Sample Report
Acute left subdural hematoma measuring up to 2 cm in thickness with areas of internal hypoattenuation compatible with unclotted (hyperacute) hemorrhage.
Associated left greater than right cerebral hemispheric sulcal effacement with left to right midline shift measuring 10 mm at the foramen of Monro and medialization of the left temporal uncus with slight effacement of the suprasellar cistern. No downward transtentorial or cerebellar tonsillar herniation.
Partial effacement of the left lateral ventricle. Dilation of the right lateral ventricle raises concern for ventricular entrapment with developing noncommunicating hydrocephalus.
No acute calvarial fracture.
Sequelae of right frontal craniotomy for hematoma evacuation with associated encephalomalacia in the right frontal lobe.
Discussion