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Updated: Aug 25, 2026

Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression

Published on: May 7, 2019

Diffuse dural gadolinium MRI enhancement associated with bilateral chronic subdural hematomas

Svetlana Blitshteyn1, Laszlo L Mechtler, Rohit Bakshi

  • 1Department of Neurology, Mayo Clinic Jacksonville, Mayo College of Medicine, Jacksonville, FL, USA.

Clinical Imaging
|March 31, 2004
PubMed

Insights

Diffuse dural enhancement on MRI scans in chronic subdural hematomas (CSDHs) does not always signal infection or malignancy. CSDH should be considered in differential diagnoses for diffuse dural enhancement, especially with clinical indicators.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Chronic subdural hematomas (CSDHs) are often associated with cognitive dysfunction and a history of head trauma.
  • Localized dural enhancement on postcontrast MRI, linked to the CSDH membrane, is a known finding.

Observation:

  • An 83-year-old male presented with rapid cognitive decline four weeks post-head trauma.
  • MRI revealed CSDHs with localized dural enhancement and a significant, diffuse, symmetric pachymeningeal enhancement throughout the intracranial dura.

Findings:

  • Meningeal biopsy excluded infectious or neoplastic etiologies for the enhancement, showing only fibrocollagenous changes.
  • The diffuse dural enhancement was attributed to the CSDH itself, not a secondary process.

Implications:

  • Diffuse dural enhancement in MRI findings associated with CSDH does not necessitate a superimposed infection or malignancy.
  • CSDH should be included in the differential diagnosis for diffuse dural enhancement, particularly when clinical presentation aligns.

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