PMC5551284_01
Initial CT findings of left frontoparietal extra-axial hyperdensity and accompanying left-to-right shift of the ventricular system representing an acute SDH and its resultant mass effect (a) with subsequent progression (b). Following craniotomy and bone flap replacement there is recurrence (c). After reoperation for craniectomy, ventricles assume a more midline position (d). 2 months postoperatively, the brain has a sunken appearance and residual postoperative fluid has disappeared (e). Following cranioplasty the brain assumes its normal appearance (f)
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F1
A computed tomography (CT) scan of the head demonstrated a 13-mm, left-sided lentiform-shaped hyperdensity suggestive of subdural hematoma with midline shift of 7 mm and minimal transtentorial herniation [Figure 1a]. Repeat head CT at that time revealed the SDH had increased to a maximum width of 16 mm and midline shift of 9.5 mm [Figure 1b]. SDH [Figure 1c]. She was taken emergently to the operating room for reopening of the craniotomy and evacuation of the hematoma. A postoperative CT scan demonstrated resolution of midline shift and some persistent fluid within the operative bed [Figure 1d]. Her 2-month postoperative scan showed resolution of fluid in the operative bed [Figure 1e]. She underwent cranioplasty roughly 6 months after the initial surgery [Figure 1f].