Concluded Case

Acute on chronic Rt FTP SDH and Left Parietal acute on chro SDH

New Case 71 yr ,M, Known Diabetic and hypertensive Presented with history of fall February 16th ,hit by a vehicle. Transient confusion,evaluated at local hospital,CT brain was reported as normal and noted no clinical signs of TBI. He was doing well till 1 week ago and was attended OPD on 17th April with slowness of gait ,precipitancy of micturition with mild memory impairement in the form of getting the name of his sons and grand children's . On exam vitals stable, intact cranial nerves,gr5/ 5 power both sides, bilateral hyperreflexes of knees with difficulty in tandom walking. what abnormality in the CT brain and what is the diagnosis?

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Concluded answer

Thanks Curofy and others who answered .Discussion : What abnormality in the CT brain and What is the diagnosis?. * Large multilobulated heterodense chronic SDH involving Rt frontotemopiparietal convexity.Dependent hyperdensity with in the few circulations.Significant mass effect in the form of effacement of adjacent cortical sulci,frontal horn,body occipital horn of rt lateral ventricle. * Rt uncal herniation with mild midbrain rotation and subfalcian herniation to left. * Another mixed density lesion noted in the left perietal convexity. Conclusion: 1.Acute on chronic SDH rt frontotemporoparietal with midline shift ,uncal and sub falcine herniation. 2.Left parietal convexity acute on chronic SDH Burrhole evacuation done ,pt is discharged in a good condition. .

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Thanks Curofy
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Thanks Curofy and others who answered .Discussion : What abnormality in the CT brain and What is the diagnosis?. * Large multilobulated heterodense chronic SDH involving Rt frontotemopiparietal convexity.Dependent hyperdensity with in the few circulations.Significant mass effect in the form of effacement of adjacent cortical sulci,frontal horn,body occipital horn of rt lateral ventricle. * Rt uncal herniation with mild midbrain rotation and subfalcian herniation to left. * Another mixed density lesion noted in the left perietal convexity. Conclusion: 1.Acute on chronic SDH rt frontotemporoparietal with midline shift ,uncal and sub falcine herniation. 2.Left parietal convexity acute on chronic SDH Burrhole evacuation done ,pt is discharged in a good condition. .

Bilateral chronic sdh.. rt. Is multiseptate.. needs surgery .. experience needed to identify and drain all loculi

I agree
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Rt subacute subdural heamato a with mass effect with mild mid line shift

Dr Jain, Pl check something on the left side also.
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SUB DURAL HAEMATOMA WITH MID LINE SHIFT

Thank you doctor
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chronic with subacute SDH Need urgent evacuation of clot

Thanks Dr Tomar,something on the left side also
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Subarachnoid hmg admit n stabilise with IV mannitol or 25% dextrose

Sorry subdural
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Diagnosis SDH. Management Burr hole & evacuation of clot

Thank you doctor
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