Sunday, December 9, 2018

MRI in acute and subacute SDH

Q: what makes subacute Sub Dural Hematoma (SDH) appear brighter on the Magnetic Resonance Imaging (MRI) than acute SDH?

Answer:  Acute, sub-acute, and chronic SDH are classified according to time periods. SDH happening within 48 hours are labeled as acute, up to two weeks as subacute and afterward as chronic SDH. This classification determines the clinical management.

The most important clinical determination clinicians have to make is between acute and subacute/chronic SDH. The acute clot only has the presence of deoxyhemoglobin and appears hypointense on T2-weighted images. Over days deoxyhemoglobin degrades to methemoglobin, and appears bright on both T1 and T2-weighted images.



Atlas SW, Thulborn KR. Intracranial hemorrhage. Magnetic Resonance Imaging of the Brain and Spine. 3rd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2002. 773-832.

No comments:

Post a Comment