CT findings in a case of neonatal acute subdural hematoma

Summary The CT findings in a case of neonatal acute subdural hematoma are presented. CT demonstrated a crescentic high density area in the subdural space over the left cerebral hemisphere and an oval high density area in the left occipital region. The latter was suspected of being an intracerebral hematoma. Emergency craniotomy revealed that the high density area was due to a subdural hematoma between the occipital lobe and the tentorium cerebelli.     

Acute spinal subdural hematoma: MR and CT findings with pathologic correlates.

PURPOSETo determine the MR and CT findings that characterize acute spinal subdural hematoma (ASSH).METHODSThe MR, CT, and clinical findings in three patients with surgically proved ASSH were reviewed and also correlated with the postmortem MR, CT, and cryomicrotome findings in three other patients, two with ASSH and one with an acute spinal epidural hematoma.RESULTSImaging findings in ASSH included: (a) hyperdense lesions on plain CT within the dural sac, distinct from the adjacent low-density epidural fat and silhouetted against the lower-density spinal cord and cauda equina, which it compressed; (b) lack of direct continuity with the adjacent osseous structures; (c) clumping, loculation, and streaking of blood within the dural sac on both MR and Ct; and (d) an inhomogeneous and variable signal intensity to the ASSH on all MR pulse sequences, but, nevertheless, a striking low signal intensity on T2-weighted spin-echo or T2-weighted gradient-echo to a major part of the ASSH because of deoxyhemoglobin. Plain CT was most helpful in compartmentalizing the hematoma.CONCLUSIONWhen MR and plain CT are obtained as complementary studies, they provide characteristic findings that allow the prompt diagnosis of ASSH.     

等密度硬膜下血肿的CT表现

目的分析等密度硬膜下血肿(SDH)的CT影像学特点,提高对等密度SDH的诊断准确率。方法．12例等密度SDH行CT平扫后9例行增强扫描,男9例,女3例,年龄23～71岁,平均年龄55岁。临床主要表现为头痛,一侧或双侧肢体无力并逐渐加重。结果等密度SDH中：位于左侧7例,右侧4例,双侧1例。增强后病灶均不强化,可见到皮层静脉内移。12例均可见到灰白质界面内移;中线移位,脑室变形及患侧脑沟消失11例。1例双侧等密度SDH中线无移位．结论颅骨内板下等密度无强化病灶,造成中线移位、脑室变形、脑沟消失,灰白质界面及皮层静脉内移。或中线无移位但有以上其它征象的即可确立一侧或双侧等密度SDH的诊断。     

等密度硬膜下血肿的CT诊断

探讨CT对等密度硬膜下血肿的诊断价值，认为CT诊断硬膜下血肿的准确率非常高，目前CT已成为该疾病的首选检查手段。     

等密度硬膜下血肿的CT诊断

等密度硬膜下血肿(简称ISDH)，是硬膜下血肿中的常见类型，由于该血肿的密度与脑实质密度接近，且与脑实质分界不清，部分病人可有或无明确颅脑外伤，有时诊断较难。甚至有可能造成漏诊或误诊，本文回顾性分析经临床证实的46例等密度硬膜下血肿病例，旨在进一步提高对本病的认识     

少见部位硬膜下血肿的CT诊断

大脑镰、小脑幕硬膜下血肿是硬膜下血肿的一种少见类型,有关文献对其描述并不多见,由于认识不足,往往导致CT对该病的漏诊或误诊,最常见误诊为蛛网膜下腔出血及小脑出血。我们回顾性分析了40例大脑镰、小脑幕硬膜下血肿的CT表现,旨在提高对其CT表现的认识,提高诊断和鉴别诊断水平。1材料与方法1·1一般资料本组40例,其中男22例,女18例;年龄15~70岁,平均52·6岁。有明确颅脑外伤史39例,再生障碍性贫血1例。39例外伤患者中,车祸24例,暴力伤8例,坠落伤7例。临床症状为头痛、头晕、恶心、呕吐33例,有短暂昏迷史、意识障碍7例。8例在受伤后6~15…     

Spontaneous spinal subdural hematoma: MRI findings in two cases

Spontaneous spinal subdural hematoma is an uncommon finding. This report of two cases of spinal subdural hematoma (one hyperacute and one subacute) discusses the current theory of how it develops, the MRI findings, its differentiation from spinal epidural hematoma, and the value of MRI in monitoring patients undergoing conservative treatment. The most significant MRI findings in the hyperacute phase were isointense signal on T1-weighted sequences and hyperintense signal on T2-weighted sequences. Moreover, T2-weighted gradient-echo sequences showed a hypointense peripheral ring. In the subacute phase, a hyperintense signal was seen on T1-, T1-fat-suppression, and T2-weighted sequences.     

Evolution of CT findings in hepatic hematoma

This report evaluates the CT findings of posttraumatic, intrahepatic lesions in 10 patients. The change in appearance of the lesions on follow-up examinations, in the absence of surgical intervention, is described. Similar lesions were produced in dogs and are compared with the human lesions and with hematomas in nonhepatic tissue.     

慢性硬膜下血肿的CT分型与临床意义

慢性硬膜下血肿较少见,由于外伤史不明确或仅有轻微的外伤史,症状及体征不典型,临床上常易误诊或漏诊.笔者收集2005年1月～2009年12月两家医院治疗的慢性硬膜下血肿病例46例,分析其CT表现与临床关系,以指导临床制订合理的治疗方案.     

Acute subdural hematomas: atypical CT findings

Seventy-one patients with acute subdural hematomas were examined by CT within 72 hr of a documented head injury. Lesions often did not have the classical appearance of a homogeneous, high-density extracerebral collection of blood in a crescentic configuration. Specifically, 28 patients (39%) had mixed-density subdural hematomas (MDSDH) with various degrees of low-density blood within the subdural space. In 10 of these 28 patients, the hematoma had a relatively localized mass effect with a convex inner margin, occasionally mimicking the appearance of an epidural hematoma. The MDSDH group differed from the typical homogeneous high-density subdural hematomas in that they were larger (average maximal thickness was 18.1 mm versus 8.0 mm), had more midline shift, and had a higher mortality rate (50% versus 26%). Four patients with MDSDH demonstrated an unusual pattern of ventricular compression with trapping of cerebrospinal fluid in the body of the ipsilateral ventricle and compression of the body of the contralateral ventricle. This pattern has to our knowledge not been previously described. Possible causes of the low-density regions within the hematomas include unclotted blood in an early stage of hematoma development, serum extruded during the early phase of clot retraction, or cerebrospinal fluid within the subdural space due to an arachnoid tear.     

非常见部位急性硬膜下血肿26例CT诊断

急性硬膜下血肿多位于颅骨内板下 ,根据血肿形态、密度变化与占位效应等在颅脑外伤急诊ＣＴ诊断中并无困难[1] 。但在实际工作中 ,位于大脑镰、小脑幕或额颞底部等非常见部位的急性硬膜下血肿 ,常被误认为蛛网膜下腔出血等。我们收集此类非常见部位的急性硬膜下血肿 2 6例 ,分析ＣＴ表现 ,以提高对本病的认识。1　资料和方法　1 1　临床资料　 2 6例患者中 ,因头部各类撞击伤、摔伤等在1ｄ内行ＣＴ检查 19例 ,2～ 3ｄ行ＣＴ检查 7例。男 17例 ,女 9例。年龄 19～ 6 7岁 ,平均年龄 37 8岁。 2 4例大脑镰、小脑幕急性硬膜下血肿 ,除 7例因合并…     

Middle fossa arachnoid cyst and subdural hematoma: CT studies

A patient with a history of previous head injury presented with an isodense subdural hematoma with extension into a preexisting middle fossa arachnoid cyst. The latter, suspected on the basis of findings pointing to chronic expansion of the middle fossa, was confirmed in a repeat CT study carried out after evacuation of the hematoma.     

自发性硬膜下血肿的临床及CT分析

目的:分析自发性硬膜下血肿的临床和CT表现特点,提高本病的认识。方法:回顾分析16例自发性硬膜下血肿的CT和临床资料。结果:CT表现:血肿多位于大脑突面,多累及2~3个部位。急性期4例,亚急性期6例,慢性期6例,均表现为颅内板下弧形,“3”字形,新月状不同密度影,最大血肿厚度大于10mm有8例,不同程度的脑中线移位。临床表现:除1例快速进入昏迷外,其余早期表现为头痛、头晕,恶心、呕吐,易疲劳,智力衰退、模糊,继而出现偏瘫,意识障碍,昏迷等,11例经内科保守治疗和4例外科手术治疗患者症状明显好转和痊愈。结论:自发性硬膜下血肿多见于老年人,CT表现以亚急性期和慢性期多见,且出血量大而范围广,脑中线移位明显。临床起病隐袭,早期临床表现无特异性,症状加重时往往出血量大,早期易延误诊断,及时治疗临床效果好。     

Fat deposition adjacent to chronic subdural hematoma: CT demonstration

Computed tomography of the head in a patient with bilateral chronic subdural hematomas demonstrated areas of fat density closely approximating the hematomas. The persistent fatty nature of the CT finding was confirmed by subsequent magnetic resonance and CT performed 1 month and 3 years later. Although an intracerebral hemorrhage with transient presence of fatty material has been described in an alcoholic hyperlipemic patient, this case shows fatty deposition adjacent ot subdural hemorrhage without any known predisposing factors.     

Isodense subdural haematomas on CT: MRI findings

Summary MRI findings are described in two patients with subdural haematomas isodense on CT. In one patient, admitted 6 weeks after trauma, a chronic subdural haematoma showed extreme hypointensity on T2-weighted images, suggesting acute trauma, and therefore acute rebleeding. In the second patient with severe anaemia, an acute subdural haematoma was hyperintense on T2-weighted images, suggesting chronic trauma; this may be explained by the low haematocrit and a possible mixture of blood with cerebrospinal fluid. The MRI features of subdural haematomas and hygromas have to be kept in mind, in order not to misjudge the age of the haematoma.