MD, Professor of Radiology, University Distinguished William H. and Patricia W. Child Presidential Endowed Chair in Radiology, Department of Radiology, University of Utah School of Medicine, Salt Lake City, UT USA
Not all epidural hematomas are the same, with different imaging findings and clinical implications. This lecture distinguishes between “classic” EDHs and less common variant types such as “vertex” venous EDHs, anterior middle fossa EDHs and clival EDHs in children. New data on isolated peritentorial acute subdural hematomas (aSDHs) has demonstrated that these thin blood collections do not enlarge and therefore do not need interval followup. The brain UNDER convexity SDHs may show significant perfusion alterations so beware the elderly patient with a minor fall who has mass effect disproportionate to the size of the SDH as it may be the manifestation of impending disastrous brain swelling. A new concept in head trauma imaging that will be discussed is the hematohygroma and its implications in abusive head trauma.