Differential CT features of acute lentiform subdural hematoma and epidural hematoma
Journal
Clinical Neurology and Neurosurgery
Journal Volume
112
Journal Issue
7
Pages
552-556
Date Issued
2010
Author(s)
Abstract
Objectives: Acute subdural hematoma (SDH) normally appears as a panhemispheric collection of blood with a crescent configuration. However, a number of SDH show lentiform appearances, mimicking acute epidural hematoma (EDH). In this study, we reported our experiences with this special disease entity. Radiological features that aided in the accurate localization of the hematoma were also addressed. Patients and methods: From among 51 acute SDH cases who were surgically treated between July 2007 and April 2008, five cases whose SDH had a localized convex appearance were enrolled. Surgical records and CT images were retrospectively reviewed. Important CT features that could differentiate lentiform SDH from EDH were especially analyzed. Results: Subdural adhesions were major causes of localized SDH in four out of five patients, all of whom had previous neurosurgical interventions or radiotherapy. Though those hematomas appeared as biconvex on CT scans, four differential features could be identified in favor of SDH. These included a crescentic tail, an obtuse angle at the margin of the hematoma, a dural line above the hematoma and a direct connection to the underlying intracerebral hematomas. Conclusions: Biconvex localized SDH might be misinterpreted as acute EDH if the diagnosis is based on the shape of the hematoma alone. This study emphasized that a detailed evaluation of surgical histories and CT features are mandatory in differentiating lentiform SDH and EDH. ? 2010 Elsevier B.V. All rights reserved.
SDGs
Other Subjects
adult; aged; article; brain hematoma; computer assisted tomography; epidural hematoma; female; human; image analysis; major clinical study; male; medical record review; subdural hematoma; computer assisted tomography; differential diagnosis; Hematoma, Epidural, Spinal; Hematoma, Subdural, Spinal; intervertebral diskectomy; low back pain; mental health; middle aged; prospective study; quality of life; questionnaire; radiography; treatment outcome; young adult; Adult; Diagnosis, Differential; Diskectomy; Female; Hematoma, Epidural, Spinal; Hematoma, Subdural, Spinal; Humans; Low Back Pain; Male; Mental Health; Middle Aged; Prospective Studies; Quality of Life; Questionnaires; Tomography, X-Ray Computed; Treatment Outcome; Young Adult; Adult; Diagnosis, Differential; Diskectomy; Female; Hematoma, Epidural, Spinal; Hematoma, Subdural, Spinal; Humans; Low Back Pain; Male; Mental Health; Middle Aged; Prospective Studies; Quality of Life; Questionnaires; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
Type
journal article