70 years old, male, previous falls 3 weeks ago. Headache, le | Figure 1

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Case Overview

70 years old, male, previous falls 3 weeks ago. Headache, left hemiparesis (4/5) and dysarthria starting 5 days ago. Brain CT shows right hemispheric subacute subdural hematoma, brain compression and midline shift. We perform evacuation through burr holes.

Please note that brain parenchyma and hematoma have similar density, so in some cases, diagnosis may be overlooked.

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Update from prior case. This patient had bilateral chronic subdural hematoma. The blood was isodense with the brain. One hematoma counter effects the mass of each other giving the appearance of a symmetric brain. Sulci is gone because of mass effect but not obvious shifting in the midline. This very symptomatic patient was taken to surgery. I in this case have marked the areas of the hematoma. The presence of bilateral hematoma also gave bilateral findings in the physical examination. There was history of trauma 6 weeks ago.

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