Subacute subdural hematoma

Case contributed by Dr Fakhry Mahmoud Ebouda


Headache then impaired consciousness in a female patient with valve replacement receiving anticoagulants.

Patient Data

Age: 30 years
Gender: Female

A crescentic shaped abnormality - a feature of hematoma - is seen along the right side of cerebral parenchyma.

It is isodense by comparing to the related cerebral parenchyma. It exerts mass effect in the form of effacement of the related cortical sulci, compression of the right lateral ventricle with slight mid line shift.


Right sided subdural hematoma, more eloquently observed on MRI with mass effect.

Case Discussion

Subdural hemorrhage (SDH) is the presence of blood between the dura and arachnoid mater of the meninges so termed extraaxial.

In the subacute stage, a subdural hematoma appears isodense to surrounding brain parenchyma. This makes hard to be differentiated from brain parenchyma.Note it is indirect effect in the form of  mass effect described above.

MRI offers more characterization of aging hematoma.  It appears bright on T1 and on T2 owing to extracellular met hemoglobin of late subacute hematoma

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Case information

rID: 27099
Published: 20th Jan 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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