UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD
Pagination or Media Count:
Subdural hematoma is a common injury in both military active duty and their dependents, including children subject to nonaccidental trauma. The subdural hematoma SDH is a potentially devastating, yet curable extraaxial fluid collection classically associated with head trauma including rapid acceleration or deceleration that produces tearing of the bridging veins as they cross from brain to dural sinus. Clinical manifestations may be nonfocal and nonspecific and a careful history taking and an appropriate degree of clinical suspicion are necessary for timely diagnosis. A noncontrast head CT is fast, highly accurate, and with few exceptions, should always be the first study obtained in the evaluation of acute head trauma. MR imaging--especially FLAIR and diffusion sequences--is useful for its ability to determine the age of the hematoma and is superior for the identification and characterization of more subtle associated CNS injuries. Treatment of nonacute subdural hematoma may involve craniotomy-guided hematoma evacuation, depending on the size and the amount of mass effect.
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