Patient Data
A non-contrast CT scan demonstrates a right parieto-occipital scalp hematoma.
A thin right parieto-occipital subdural collection isodense to the cortex. Given that the patient fell and hit her head 45 minutes ago, this suggests that this could be a hyperacute subdural hematoma.
The scan was otherwise unremarkable.
A follow-up CT scan was recommended after 12 hours.
A follow-up non-contrast CT of the brain after 12 hours demonstrates a small right acute subdural parieto-occipital hematoma and layering of the hematoma on the right tentorium.
Case Discussion
This case demonstrates how a thin, hyperacute subdural hematoma can be easily missed because it is isodense to the cortex.