Case 2: Discussion Continued

Non Contrast Head CT examination

In this example, this patient has a hematoma that follows the contour of the the entire right cerebral hemisphere and is crescent shaped (blue arrows). Notice how the hematoma is not bounded by suture lines and does not cross midline. Notice how the hematoma stops at the midline and is bound by the falx (white arrow), the dural reflection that separates the right and left cerebral hemispheres. This hematoma is located within the subdural space and is often caused by injury to bridging veins. Notice on the diagram below how subdural hematomas cannot cross at the midline because they are bound by the falx. Epidural hematomas can cross at the midline because they are located above the dura. This characteristic can be a distinguishing feature between epidural and subdural hematomas.