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[Chronic subdural hematoma: diagnostic imaging studies].

M Guénot1

  • 1Service de Neurochirurgie A (Pr Sindou), Hôpital Neurologique P.-Wertheimer, 59, boulevard Pinel, 69003 Lyon. marc.guenot@chu-lyon.fr

Neuro-Chirurgie
|March 28, 2002
PubMed
Summary

Computed tomography (CT) scans diagnose chronic subdural hematoma over 90% of the time. Magnetic resonance imaging (MRI) confirms diagnosis in nearly all cases, with imaging characteristics varying by hematoma age.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Context:

  • Chronic subdural hematoma (CSH) diagnosis relies heavily on imaging.
  • CT scans are the primary diagnostic tool, offering high sensitivity.
  • MRI provides detailed characterization, especially for complex or subtle cases.

Purpose:

  • To outline the diagnostic capabilities of CT and MRI for chronic subdural hematoma.
  • To describe characteristic imaging findings on CT and MRI.
  • To highlight diagnostic challenges and rare presentations of CSH.

Summary:

  • CT scans diagnose chronic subdural hematoma in over 90% of cases, typically showing a peri-cerebral fluid collection with specific border characteristics.
  • Hematoma density on CT and intensity on MRI (T1 and T2 sequences) vary with age.

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  • Diagnostic challenges include bilateral isodense hematomas and differentiating CSH from hygroma or empyema. Rare locations and heterogeneous appearances can also occur.
  • MRI confirms CSH in nearly 100% of cases, with signal intensity dependent on hematoma age.

    • Impact:

    • Accurate and timely diagnosis of chronic subdural hematoma is crucial for effective patient management.
    • Understanding imaging nuances aids in differentiating CSH from other pathologies.
    • This information supports radiologists and clinicians in interpreting neuroimaging for CSH.