IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Chronic subdural hematoma - importance of dural membranes

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Past history of obstructive hydrocephalus treated with shunting. Now headache and lethargy.

Patient Data

Age: 75 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Thin slightly hyperdense membranes paralleling the skull vault and cerebrum are a feature of chronic subdural hematomas.

A section of dura from the vertex of the skull removed at autopsy showing normal dura to the right of the sagittal sinus and chronic hematoma on the left containing a prominent membrane.

Case Discussion

Thin slightly hyperdense membranes paralleling the skull vault and cerebrum are a feature of chronic subdural hematomas, indeed pathologists rely on the detection of these membranes at autopsy to confirm chronic blood consistent with hygroma. The same can be used on CT or MRI, i.e. if extra-axial membranes are detected on imaging then there are definitely chronic subdural blood collections rather than just prominent CSF spaces or bland hygromas. In this case, they are probably the result of "overshunting".

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.