Neuroimaging Cases 005

Subdural hematomas

Latest instalment in our neuroimaging series. Images, text and cases collated by Madison Watts MD, Rebecca DeCarlo MD, Faith Meyers MD and Steven Perry MD. First published on EMGuideWire.com and peer reviewed by Professor Michael Gibbs.

References

• Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger JE; Surgical Management of Traumatic Brain Injury Author Group. Surgical management of acute subdural hematomas. Neurosurgery. 2006 Mar;58(3 Suppl):S16-24; discussion Si-iv. 
• Walcott BP, Khanna A, Kwon CS, Phillips HW, Nahed BV, Coumans JV. Time interval to surgery and outcomes following the surgical treatment of acute traumatic subdural hematoma. J Clin Neurosci. 2014 Dec;21(12):2107-11
• Tien HC, Jung V, Pinto R, Mainprize T, Scales DC, Rizoli SB. Reducing time-to-treatment decreases mortality of trauma patients with acute subdural hematoma. Ann Surg. 2011 Jun;253(6):1178-83.
• Hutchinson PJ et al. Decompressive Craniectomy versus Craniotomy for Acute Subdural Hematoma. N Engl J Med. 2023 Jun 15;388(24):2219-2229. 
• Gopinath S. Traumatic Acute Subdural Hematoma – Should the Bone Flap Be Removed or Replaced? N Engl J Med. 2023 Jun 15;388(24):2288-2289.
• Pruitt P, Ornam JV, Borczuk P. A Decision Instrument to Identify Isolated Traumatic Subdural Hematomas at Low Risk of Neurologic Deterioration, Surgical Intervention, or Radiographic Worsening. Acad Emerg Med. 2017 Nov;24(11):1377-1386. 
• Pruitt P, Castillo R, Rogers A, Prabhakaran S, Muschong K, Scudder M, McCarthy DM, Holl JL, Courtney DM, Borczuk P, Naidech A. External Validation of a Tool to Identify Low-Risk Patients With Isolated Subdural Hematoma and Preserved Consciousness. Ann Emerg Med. 2023 Sep 18:S0196-0644(23)01138-1.

This neuroimaging interpretation series is proudly sponsored by the Emergency Medicine Residency Program at Carolinas Medical Center. The goal is to promote widespread mastery of CXR interpretation. There is no personal health information [PHI] within, and ages have been changed to protect patient confidentiality.