Acute Subdural Haematomas

KNOW THE SIGNS, PREVENT DEATH AND DISABILITY

CT scan slice showing an intracerebral haematoma associated with an acute subdural haematoma. There is significant swelling in the whole brain and evidence of brain shift. The right temporal horn of the ventricle is not seen and on the left, it is slightly dilated. The full extent of the subdural clot on the surface of the brain is shown below. This image also details the significant brain shift to the left side (your right hand side, but the left hemisphere of the patients brain on CT scan).

The patient presented with collapse and unconsciousness. The GCS was 4 on admission. CT angiography and cerebral angiography were performed to reveal a complex aneurysm in the right middle cerebral artery territory (see below). It was not suitable for coiling and the patient died quite quickly.

Image: courtesy of Dr. T Elias, July 2002

Created by B I Ogungbo in September 2002. Modified January 2008. ©