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Bilateral subdural hemorrhage

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Fall from standing height.

Patient Data

Age: 80 years
Gender: Female

Bifrontal subdural collections have developed which are isointense to brain and measures up to 8 mm in depth on the right and 6mm in depth on the left, both extending over the frontal and parietal convexities. There is no midline shift. The ventricles are normal in size. The basal cisterns are not effaced. There is no intra-axial hemorrhage. The previously seen bifrontal parenchymal hyperdensities suspicious for contusion are no longer evident.

Case Discussion

Bilateral subdural collections can cause significant mass effect without midline shift. As such transtentorial herniation needs to be assessed. 

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