Board Review 3 – Case 13

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case shows a left frontal hyperdense collection on a CT. The patient is on anticoagulation.

The diagnosis is: subdural hematoma

Subdural hematomas are extra-axial hemorrhages that are common in the elderly, particularly those who are on anticoagulation. They have the highest mortality of intracranial hemorrhages. Key features are an extra-axial hemorrhage that has a crescent shape that crosses sutures and tracks along dural reflections such as the falx and tentorium.

Epidural hematomas do not cross sutures because the outer layers of the dura are adherent to the bone and continuous with the periosteum. Most epidural hematomas are associated with skull fractures.