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• W2002829822 abstract "SUBDURAL hematomas are shown angiographically by a space, particularly on the anteroposterior projection, between vessels on the cerebral convexity and the inner table of the skull (l) . When the subdural hematoma is associated with a recent history the clear space is parallel to the calvaria, but more chronic subdural hematomas are characterized by a clear space with a convex or lens-shaped border (2). The diagnosis of subdural hematomas based on these angiographic criteria must not be allowed to become a reflex, however, because this will lead to misinterpretations. Other causes for clear areas between convexity vessels and the calvaria exist and should be borne in mind, including epidural hematomas and subdural or epidural spaceoccupying tumors or inflammatory processes (3, 4). Cortical atrophy can result in convexity vessels shrinking away from the inner surface of the calvaria. If this atrophy occurs uniformly, as in Alzheimer's disease, it can cause a parallel clear zone simulating the appearance of acute subdural hematoma (4) . If the atrophy is post-traumatic, particularly postsurgical, adhesions to the dura form with the underlying brain between adhesions undergoing a separation from the calvaria because of atrophy. Thus, a convex area, clear of vessels on arteriography, may form and have the appearance of a chronic subdural hematoma on the angiogram. On angiography cerebrovascular occlusive disease can lead to a lack of filling of peripheral portions of the vascular supply. This may approximate the appearance of either an acute or a chronic subdural hematoma. However, unlike the situation discussed above with atrophy and subdural or epidural space-occupying lesions where differentiation may not be possible by radiographic means alone, the diagnosis of occlusive disease can usually be made by a study of sequential arteriographic films. This, together with the frequency of vascular disease in the population at large, makes it important to bear in mind occlusive disease when dealing with the diagnosis of subdural hematoma. In this communication three cases are reported which were presented clinically and on provisional radiographic interpretation as subdural hematoma or possible subdural hematoma; later they were proved to be vascular disease. CASE I: L. S., a 75-year-old right-handed white woman, was transferred to Bellevue Hospital on Oct. 1, 1964. She had been treated for five years for auricular fibrillation and hypertension. Three years prior to admission a right cerebrovascular accident left her with some residual hemiparesis. On admission to Bellevue Hospital, the patient was quiet and co-operative but confused and disoriented in all spheres. Neurologically, the right pupil was larger than the left, both were reactive, and a right supranuclear facial weakness and mild right hemiparesis were noted. On Oct. 5 the patient became more lethargic and responded only to deep pain. Her left extremities became flaccid, and bilateral Babinski reflexes developed." @default.
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• W2002829822 date "1967-01-01" @default.
• W2002829822 modified "2023-09-27" @default.
• W2002829822 title "Cerebrovascular Occlusive Disease as a Differential Diagnosis in Subdural Hematomas" @default.
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• W2002829822 doi "https://doi.org/10.1148/88.1.85" @default.
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