Analysis of the clinical and computed tomographic findings in isodense subdural hematoma

The clinical and CT findings in 20 patients with isodense subdural hematomas (SDH) are analyzed. The lesions were unilateral in 15 and bilateral in 5 cases. Three patients presented with episodes of transient neurological deficit. Eleven patients presented with the sudden onset of fixed focal neurological deficit. Nineteen of 20 patients had abnormal neurological findings on the initial neurological examination. In those patients with unilateral SDH, CT showed ventricular mass effect, midline shift, and sulcal space effacement in all cases. There was medial membrane enhancement in 12 cases. In the 5 cases of bilaterial isodense SDH, the lesions were of different sizes in 3 and of equal size in two cases. The bilateral SDH showed ventricular mass effect and sulcal space effacement; however midline shift was seen in only three and none showed medial membrane enhancement.