İzodens/subakut subdural hematom

Özet

Subakut subdural hematom, zamanla dansitesi azalarak beyin korteksine yaklaşan ve bu yüzden rutin pencerede silik kalabilen ekstraaksiyel kanamadır. Kontrastsız BT'de tanı çoğu kez koleksiyonun kendisinden çok sulkus, ventrikül ve gri-beyaz bileşke üzerindeki yer değiştirme etkilerinden çıkarılır. Bilateral koleksiyonlarda kitle etkisi, orta hat kayması olmaksızın bile ventriküler bası ve sulkus silinmesi ile izlenebilir. İzodens bir koleksiyonun atlanması, devam eden bası ve altta yatan kanama yükünün gözden kaçmasına neden olabilir.

Faz ve pencere

Kontrastsız tanısal

Subdural koleksiyonda kitle etkisini değerlendirirken sulkus obliterasyonu ve ventrikül basısı gibi bulguları arayın. Kontrastsız BT'de atipik veya belirsiz subdural koleksiyonlarda, dural neoplazi gibi taklitçileri dışlamak için kontrastlı görüntüleme düşünülebilir.

Önerilen pencereler: Beyin (G 80 / M 40), Subdural (G 200 / M 75).

BT bulguları

• BT'de izodens subakut subdural hematom görülebilir.
• Subdural koleksiyonda sulkusların silinmesi, kitle etkisi bulgusu olabilir.
• İzodens subakut subdural hematom alttaki beyin üzerinde kitle etkisi oluşturabilir; bu etki sulkus silinmesi veya ventrikül basısı olarak görülebilir.
• İpsilateral lateral ventrikül daralması ve şekil bozukluğu, belirgin dansite farkı olmadan kitle etkisinin göstergesidir.
• Bilateral izodens koleksiyonlar kitle etkisi yaratabilir; bu durumda tanı orta hat kaymasız bile ventriküler bası ve sulkus silinmesiyle konur.
• Koleksiyona eşlik eden daha hiperdens odak, farklı yoğunlukta kan ürünlerini veya yakın zamanda eklenen kanı düşündürür.

Normalde

İzodens koleksiyonda kitle etkisini değerlendirirken sulkus silinmesi ve ventrikül basısı gibi radyolojik bulguları ara.

Ayırıcı tanı

Kronik subdural hematom

çoğu kez BOS'a yakın hipodensdir ve membran ya da septalar gösterebilir.

Subdural higroma

kanama içermeyen, sıvı görünümünde subdural koleksiyon olarak tanımlanır.

Epidural hematom BT'de bikonveks veya lens biçimli görünür; bu şekil duranın iç tabulaya tutunmasıyla ilişkilidir.

Kortikal atrofi

sulkus ve ventriküller basılmak yerine genişler; gri-beyaz sınır içe itilmez.

Tuzaklar

• Subakut subdural hematom için kaynaklarda 3–14 gün ve 3–21 gün gibi farklı zaman aralıkları bildirilmiştir.
• Orta hat kaymasının olmaması güven vermez; sulkus silinmesi ve ventriküler bası kitle etkisinin göstergesidir.
• Kronik koleksiyon içindeki izodens kan ile tek başına dansiteyle evreleme güvenilir değildir; şekil ve komşu yapıların deformasyonu öne çıkar.
• İzodens subdural koleksiyonda kitle etkisini değerlendirirken orta hat kaymasının yanı sıra ventrikül basısı ve sulkus silinmesini de inceleyin.

Kendini dene

1. Subdural koleksiyonda kitle etkisini gösteren BT bulgularından biri hangisidir?

   • Sulkusların silinmesi
   • Sulkusların genişlemesi
   • Kalvaryumun kalınlaşması
   • Pineal bezde kalsifikasyon
   Cevabı göster

   Sulkusların silinmesi. Sulkus obliterasyonu subdural koleksiyona eşlik edebilen kitle etkisi bulgularındandır.

2. Kaynakta bildirilen izodens subakut subdural hematom alttaki beyin üzerinde hangi etkiyi oluşturmuştur?

   • Kitle etkisi
   • Ventrikül genişlemesi
   • Hidrosefali
   • Parankimal kalsifikasyon
   Cevabı göster

   Kitle etkisi. Olgu metninde izodens subakut subdural hematomun alttaki beyin üzerinde kitle etkisi oluşturduğu bildiriliyor.

İlgili konular

• Akut subdural hematom
• Kronik subdural hematom
• Akut-kronik subdural hematom
• Epidural hematom

Kaynaklar

Bu sayfadaki 31 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 20 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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79. Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
80. Diagnostic neuroimaging in neuro-ophthalmic disorders.pubmed.ncbi.nlm.nih.gov
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85. Bilateral subdural hematomas in spontaneous intracranial hypotension: A systematic review with case illustration.pubmed.ncbi.nlm.nih.gov
86. Classification of recurrence status after surgical treatment of chronic subdural hemorrhage - A machine learning approach.pubmed.ncbi.nlm.nih.gov
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93. Radiological Evaluation Criteria for Chronic Subdural Hematomas : Review of the Literature.pubmed.ncbi.nlm.nih.gov
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97. Paget's disease with tumefactive soft tissue extension mimicking a chronic subdural hematoma.pubmed.ncbi.nlm.nih.gov
98. Pre-existing statin use and recurrence in relation to hematoma architecture of chronic subdural hematomas - A propensity score-matched analysis.pubmed.ncbi.nlm.nih.gov
99. Continuum topological derivative - A novel application tool for segmentation of CT and MRI images.pubmed.ncbi.nlm.nih.gov
100. Incidence and predictors of contralateral surgery after initial unilateral evacuation of bilateral chronic subdural hematomas: A population-based cohort study.pubmed.ncbi.nlm.nih.gov
101. Analysis of risk factors for recurrence in septated chronic subdural hematoma.pubmed.ncbi.nlm.nih.gov
102. Fetal intracranial hemorrhage and infarct: Main sonographic and MRI characteristics: A review article.pubmed.ncbi.nlm.nih.gov
103. Amyloid-Related Imaging Abnormalities with Emerging Alzheimer Disease Therapeutics: Detection and Reporting Recommendations for Clinical Practice.pubmed.ncbi.nlm.nih.gov
104. Postoperative Remote Acute Subarachnoid Hemorrhage as a Complication of Chronic Subdural Hematoma Evacuation With Burrhole: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
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106. Midline Shift Induced by the Drainage of Cerebrospinal Fluid in Three Patients With External Decompression.pubmed.ncbi.nlm.nih.gov
107. Predictors of In-Hospital Mortality in Traumatic Acute Subdural Hematoma: The Role of Admission International Normalized Ratio, Imaging Parameters and Neurological Severity.pubmed.ncbi.nlm.nih.gov
108. Role of scheduled repeat CT scan in traumatic brain injuries: A prospective observational study.pubmed.ncbi.nlm.nih.gov
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110. Improved strategy for post-traumatic hydrocephalus following decompressive craniectomy: Experience of a single center.pubmed.ncbi.nlm.nih.gov
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