Presentation
Disturbed conscious level following head trauma two days ago.
Patient Data
Large left frontoparietal subdural collection that displays iso to low signal in T1, low signal on T2 and more hypointense on T2*. Associated left parietal acute infarction exhibiting restricted diffusion on DWI and hyperintense signal on T2 and FLAIR images. MRA reveals spasm of the left middle cerebral artery.
Old left cerebellar infarction, deep white matter ischemia and inovlutional changes are also noted.
Diagnosis: Acute left frontoparietal subdural hematoma and Left parietal acute infarction owing to spasm of MCA.
Case Discussion
The patient develops acute subdural hematoma following traumatic head injury which also induces arterial spasm leading to acute infarction.