An elderly man on warfarin falls and, two weeks later, becomes drowsy and confused. CT head shows a crescent-shaped collection across the cerebral convexity. What is the diagnosis?
Answer and explanation
Correct answer: D. Chronic subdural haematoma
- Step 1: A crescentic collection crossing suture lines results from bleeding from bridging veins. Step 2. It is common in the elderly, in those on anticoagulants and with alcohol excess, and symptoms may develop weeks after minor head trauma. Answer: Chronic subdural haematoma. Why not the others: Extradural haematoma is lens-shaped and bounded by sutures, from the middle meningeal artery. Subarachnoid blood fills the cisterns and sulci. A berry aneurysm bleed would be subarachnoid, not a crescentic subdural collection.
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