Dynamic/static brain scintigraphy: an effective screening test for subdural hematoma

Dynamic perfusion scintigraphy of the brain was coupled with the delayed static scan in 5,853 studies as a screening test for neurological disease. Of approximately 1,000 patients referred for investigation for possible subdural hematoma (SDH), 23 proved to have SDH at surgery. Their scintigraphic abnormalities were analyzed and classified. When neither study indicates abnormality, angiography is not required, as SDH is unlikely. When the scintigraphic appearance is characteristic of SDH, angiography or surgical exploration is mandatory, since SDH is probably present. When the scintigraphic findings are consistent with but not typical of SDH, the study remains useful as a screening procedure, but the decision to proceed with angiography is based primarily on the neurological course.