Question
A 73-year-old woman presented with chronic headache, occasional vomiting, unsteadiness and
frequent falls.
In the past few months there had been a progressive deterioration in her mental function and increasing drowsiness.
Physical examination showed moderate papilloedema but was otherwise unremarkable. A CT brain was performed .What is the probable diagnosis?
A. Subarachnoid Hemorrhage
B. Subdural Hematoma
C. Extradural Hematoma
D. Cerebral Infarct
Show Answer
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Correct Answer » B
Explanation
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Ans:B. Subdural Hematoma.
Image shows:Non-contrast axial CT of the brain shows bilateral subdural haematomas (arrows) that are acute/subacute.
Subdural haematoma
- Subdural haematomas (SDH) are caused by traumatic tear of bridging veins as they traverse the subdural space to dural venous sinuses, which are more vulnerable in elderly patients with atrophic brain and widened subdural space. Alcoholics and epileptics may develop undetected chronic subdural haematomas as they have repeated falls and the head injuries sustained are trivial and often forgotten (postictal state in epileptics).
- Also seen in infants in non-accidental injury .
CT features:
- Most are supratentorial in location
- Crescentic in shape and along the surface of the brain
- Unlike extradural haematomas subdural haematomas cross the coronal and lambdoid sutures
- Do not cross dural reflections (falx cerebri, tentorium cerebelli)
