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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Customer Question

CLINICAL INFORMATION: subdural hematoma
No prior study for comparison
The diffusion imaging technique shows no evidence of acute stroke.
There is however abnormal signal noted in the left frontal area, as well as posterior
left parietal lobe, in the extra-axial location, consistent with small subdural hematoma
The maximal thickness is 1.6 cm
There is no evidence of midline shift
Ventricle size are normal. No convincing evidence of focal mass
IMPRESSION: Left subdural hematoma as described in the frontal region.
I want to know what the results of this mri are please
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. Welcome to JA. I will review your statement and reply Shortly. Please review this preliminary respond and ask questions. We can discuss this until you are satisfied. Dr Frank

Customer: replied 1 year ago.
Customer: replied 1 year ago.
Do you think i would need surgery or the antibiotic will be enough i am on a antibiotic treatment for 8 weeks which will be due on Dec 5 on Nov 7 the empyema measured 2.3 cm by 1.5 cm and another one which measured 4mm by 9mm disapeard
Customer: replied 1 year ago.
The 2.3 cm now measures 1.6 cm
Expert:  Dr. Frank replied 1 year ago.

Hi. So the scan describes an extra-axial lesion in both the right frontal and right parietal area that based on the signal strength suggest blood, or blood products. Extra-axial means outside the brain. This is thought to be one or two (one bleed and some of the blood moved) hematomas in the subdural space. This can happen from a variety of reasons, the most common is trauma. A fall associated with alcohol is one common scenario. But any trauma, even trivial in the elderly can cause this as in the story of Ronald Reagan. The small emissary veins that inter-connect the dural or coverings of the brain break and bleed. Please get back time with questions we can discuss treatment options etc. dr Frank

Expert:  Dr. Frank replied 1 year ago.

Hi. Didn't know you were here. You had an empyema? Where was the source infection?

Customer: replied 1 year ago.
That is totally different diagnosis than the one they gave on the Nov 7 mri which diagnosed a 2.3 cm by 1.5 empyema and another 4mm by 9mm
Customer: replied 1 year ago.
I dont know
Expert:  Dr. Frank replied 1 year ago.

Hi well you should be able to tell a subdural hematoma from a subdural hygroma from a subdural empyema by mri characteristics. But your story is much more important than the scan. So you had an infection in your lung and it spread? Or what happened?

Customer: replied 1 year ago.
No I never had infections I did have 2 prior craniotomies in the past 3 months
Expert:  Dr. Frank replied 1 year ago.

Ok. So you had subdural hematomas and the craniotomy to remove them. Based on the size reduction you mentioned it is highly unlikely that you will need more surgery. They may put you on steroids to continue a reduction in size.

Expert:  Dr. Frank replied 1 year ago.

I assume you were then on antibiotics after surgery to prevent infection?

Customer: replied 1 year ago.
i had 2 craniotomies
Expert:  Dr. Frank replied 1 year ago.

How did this start? Trauma?

Customer: replied 1 year ago.
The doctors could never tell me how it started neither the bilateral subacute subdural hematoma which was the first surgery on Sep 3 2015 nor the second one which suppsedly was infection on 10/10/15 and the neurosurgeon wanted to do another surgery on Nov 8 to take out the empyema but I did not allow to it
Expert:  Dr. Frank replied 1 year ago.

Strange story but it does happen. As I mentioned you can have trivial head trauma and not remember I assume they checked you for blooding disorders. Also certain infections can make you more vulnerable to bleeding

Expert:  Dr. Frank replied 1 year ago.

But with a thickness of 1.6 cm that is pretty small and you might be able to go without surgery. Please get back to me with questions or rate my service if satisfied with this answer by clicking on the stars. Thanks. Dr Frank.