Bilateral isodense epidural hematoma: case report

Mendonça, Rodrigo; Lima, Telmo Tiburcio Fortes; Dini, Leandro Infantini; Krebs, Cláudio L.L.

doi:10.1590/s0004-282x2005000500028

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…This has also been described for extradural hematomas [ 5 – 8 ]. Other authors have reported a case of an intracerebral hematoma that appeared isodense in a patient with disseminated intravascular coagulation [ 9 ].…”

Section: Discussionmentioning

confidence: 69%

Acute isodense subdural hematoma on computed tomography scan – diagnostic and therapeutic trap: a case report

2016

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BackgroundPost-traumatic acute subdural hematomas generally appear hyperdense on a computed tomography scan. In the hyperacute stage, a subdural hematoma in rare cases appears heterogeneous with isodense images. This can pose a diagnostic problem and compromise patient care. Here we report a case of an isodense subdural hematoma and its management.Case presentationWe report the case of a 59-year-old white European man who had a serious head injury with an acute subdural hematoma. The trauma was also responsible for blood loss and hemostasis disorders. A cerebral computed tomography scan revealed an isodense subdural hematoma. Our intervention confirmed that it was an acute hematoma.ConclusionsThis unusual isodense appearance is due to anemia. It can be the cause of misdiagnosis and incorrect treatment choices.

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Section: Discussionmentioning

confidence: 69%

Acute isodense subdural hematoma on computed tomography scan – diagnostic and therapeutic trap: a case report

2016

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“…Generally, acute epidural hematoma appears hyperdense, biconvex mass lesion on CT scan. 3 But unexpectedly few cases have been reported in neurosurgical literature with acute isodense subdural and epidural hematomas. 4 Different radiological presentation of the same pathology is possibly due to decreased hematocrit level or mixing of CSF (Cerebro-spinal fluid) with blood due to dural laceration.…”

Section: Introductionmentioning

confidence: 99%

Isodense Acute Epidural Hematoma in an Anemic Patient – Diagnostic and Therapeutic Trap: A Case Report

Khan

Khan²,

Haq³

et al. 2021

Pak J Neurol Surg

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Post-traumatic acute epidural and subdural hematoma is a common neurosurgical emergency. Epidural or extradural hematoma is an accumulation of blood between the skull and dura mater, mostly appears asa hyperdense biconvex shape on computed tomography (CT) scan. In our present study, weencountered a case of an eight years old malechild brought to the hospital with head trauma in aroad traffic accident. Initial CT scan revealed an epidural hematoma, which appeared isodense rather than the usual hyperdense presentation. This unusual presentation was due to low hematocrit (HCT). Thisparticular presentation poses a diagnostic dilemma and can compromise patient managementultimately leading to treatment failure. Here, we present a case report about diagnosing and managing an anemic patient with traumatic isodense acute epidural hematoma.

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Differentiation of Hemorrhage from Iodine Using Spectral Detector CT: A Phantom Study

Hedent

Hokamp

Laukamp

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Conventional CT often cannot distinguish hemorrhage from iodine extravasation following reperfusion therapy for acute ischemic stroke. We investigated the potential of spectral detector CT in differentiating these lesions. MATERIALS AND METHODS: Centrifuged blood with increasing hematocrit (5%-85%) was used to model hemorrhage. Pure blood, blood-iodine mixtures (75/25, 50/50, and 25/75 ratios), and iodine solutions (0-14 mg I/mL) were scanned in a phantom with attenuation ranging from 12 to 75 HU on conventional imaging. Conventional and virtual noncontrast attenuation was compared and investigated for correlation with calculation of relative virtual noncontrast attenuation. Values for all investigated categories were compared using the Mann-Whitney U test. Sensitivity and specificity of virtual noncontrast, relative virtual noncontrast, conventional CT attenuation, and iodine quantification for hemorrhage detection were determined with receiver operating characteristic analysis. RESULTS: Conventional image attenuation was not significantly different among all samples containing blood (P Ͼ .05), while virtual noncontrast attenuation showed a significant decrease with a decreasing blood component (P Ͻ .01) in all blood-iodine mixtures. Relative virtual noncontrast values were significantly different among all investigated categories (P Ͻ .01), with correct hemorrhagic component size estimation for all categories within a 95% confidence interval. Areas under the curve for hemorrhage detection were 0.97, 0.87, 0.29, and 0.16 for virtual noncontrast, relative virtual noncontrast, conventional CT attenuation, and iodine quantification, respectively. A Ն10-HU virtual noncontrast, Ն20-HU virtual noncontrast, Ն40% relative virtual noncontrast, and combined Ն10-HU virtual noncontrast and Ն40% relative virtual noncontrast attenuation threshold had a sensitivity/specificity for detecting hemorrhage of 100%/23%, 89%/ 95%, 100%/82%, and 100%/100%, respectively.

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Bilateral isodense epidural hematoma: case report

Abstract: We present a case of a severe head injuried 23 year-old male patient. The initial CT scan disclosed bilateral epidural hematoma, isodense with the brain, thus being a pitfall in diagnosis. Brief case report, image and literature rewiew are presented.

Cited by 3 publications

References 4 publications

Acute isodense subdural hematoma on computed tomography scan – diagnostic and therapeutic trap: a case report

Acute isodense subdural hematoma on computed tomography scan – diagnostic and therapeutic trap: a case report

Isodense Acute Epidural Hematoma in an Anemic Patient – Diagnostic and Therapeutic Trap: A Case Report

Differentiation of Hemorrhage from Iodine Using Spectral Detector CT: A Phantom Study

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