Confirmation of traumatic interhemispheric subdural hematoma by magnetic resonance imaging

We report a case of interhemispheric subdural hematoma following closed head injury producing contralateral neurological findings and focal seizures. Non-contrast cranial computed tomography scan was initially reported to be normal, but magnetic resonance imaging of the brain demonstrated an interhemispheric subdural hematoma. Head injury, specifically occipital, is the leading cause of interhemispheric subdural hematoma in adults. Most patients develop a "falx syndrome." If adequately interpreted, magnetic resonance imaging of the brain showing the appearance of blood on T1- and T2-weighted images can detect interhemispheric subdural hematoma. However, computed tomography scan should always be done first to detect intercranial bleeding, and it should be performed with and without contrast in patients with prior head trauma and delayed bleeds.