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

Abstract

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.

Massive spontaneous subdural hemorrhage mimicking dural venous thrombosis in a sickle cell adolescent, a rare case report

“…Due to its availability and accessibility, most intracranial hemorrhages, including subdural hematoma, remain the first-line modality of diagnosis. Acute versus chronic subdural hemorrhages can also be distinguished using a plain computed tomography, with hyperdense collection in acute and hypodense in chronic situation [ 14 ]. Few exceptions acute subdural hemorrhage may appear as an isodense collection in cases of coagulopathies, anticoagulant drug use, anemia and diseases affecting red blood cell quantity such as sickle cell disease.…”

Subdural haematoma mimicking empyema in a patient with multiple sclerosis treated with immunosuppressive monoclonal antibody

“…It is usually hypodense, but isodensity can also be observed [4]. It is really important to remember that even acute SDH can appear isodense on CT scan [9]. CSDH may also cause a displacement of ventricular system and midline shift [7].…”