Head CT > Trauma > Subacute Subdural Hematoma


Subacute Subdural Hematoma

Subacute SDH may be difficult to visualize by CT because as the hemorrhage is reabsorbed it becomes isodense to normal gray matter. A subacute SDH should be suspected when you identify shift of midline structures without an obvious mass. Giving contrast may help in difficult cases because the interface between the hematoma and the adjacent brain usually becomes more obvious due to enhancement of the dura and adjacent vascular structures. Some of the notable characteristics of subacute SDH are:
- Compressed lateral ventricle
- Effaced sulci
- White matter "buckling"
- Thick cortical "mantle"



Subacute subdural hematoma (arrowheads). Note the compression of
gray and white matter in the left hemisphere due to the mass effect.


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