Concluded Case

Large left frontoparietal convexity subacute SDH

New case 54 yr ,M, Presented with left hemicranial head ache since one week. Head ache is starting from the left occipital area and then spread to whole hemicranium.Vomited three times since1 week and last episode of vomiting today morning. Almost continuous head ache ,moderate in intensity,diffuse aching type of pain. Denied having any motor or sensory symptoms. Denied having any trauma to head ,but a vuage history of slipped and about to fall but not remembering to hit his head or not known diabetic ,hypertensive and hypothyroid on regular med.Not on any antiplatelets. On exam vitals stable. Came by walking . BP 140/ 80 mmhg . Optic fundi were normal . No focal deficits. No neck stiffness. What abnormality in the CT brain?

5 Likes

LikeAnswersShare
Concluded answer

Thanks Curofy and all others who answered the case. CT brain shows large iso to mildly hyperdenseSDH noted along the left frontoparietsl convexity with maximum thickness in the left frontal region 26mm. There is compression of the underlying brain patenchyma with effacement of sulci with partial effacement of left lateral ventricle. Midline shift of 9mm to rt side with subfakcian and mild uncal herniation to rt. Mass effect noted at the region of cerebral aqueduct with mild duslatation of Rt lateral ventricle. Imp: Large left frontoparietal convexity subacute SDH.Mass effect with midline shift,subfalcine and uncal herniation to Rt. Early obstructive hydrocephalus involving Rt lateral ventricle. Left frontoparietal bur hole evacuation of SDH done as an emergency on the day of admission.Pt is already discharged in a well stable state

All Answers

Thanks Curofy and all others who answered the case. CT brain shows large iso to mildly hyperdenseSDH noted along the left frontoparietsl convexity with maximum thickness in the left frontal region 26mm. There is compression of the underlying brain patenchyma with effacement of sulci with partial effacement of left lateral ventricle. Midline shift of 9mm to rt side with subfakcian and mild uncal herniation to rt. Mass effect noted at the region of cerebral aqueduct with mild duslatation of Rt lateral ventricle. Imp: Large left frontoparietal convexity subacute SDH.Mass effect with midline shift,subfalcine and uncal herniation to Rt. Early obstructive hydrocephalus involving Rt lateral ventricle. Left frontoparietal bur hole evacuation of SDH done as an emergency on the day of admission.Pt is already discharged in a well stable state

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

chronic extradural hematoma....quite rare..either patient is on anti platelets..or he is anemic..looking at scan morphology

Valuable opinion
0

No need for MRI .CT is enough for the diagnosis.Thanks for the answer.Surgery is posted for today

There is extradural hematoma mam,surgical decompression is needed

Respected mam, I could only see a biconvex shaped slightly hyperintense opacity in the left frontal lobe, looks like epidural haematoma which is definitely causing significant midline shift, only this much I can make, I have only read subdural haematoma being subacute or chronic , don't know what is this.

Subdural haematoma lt frontal Midline shift rt Hydrocephalus Opinion of neurologist

Thank you doctor
0

Sdh with midline shift craniotomy &evauation of sdh

Valuable opinion
0

Lt sdh Decompression surgery , evacuation of haematoma

I agree
1

Do MRI brain.. In this CT there is Sub Dural Haematoma with midline shift... Requires neuro surgeon opinion and to be admitted in Neuro ICU and to start with ICP reducing medication May requires decompression surgery...

mri not indicated, ICP reducing drugs are contraindicated
2

View 1 other reply

Load more answers

Diseases Related to Discussion