What is the role of MRI in the workup of subdural hematoma (SDH)?

Updated: Jul 26, 2018
  • Author: Richard J Meagher, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

MRI is less useful than CT in diagnosing an acute subdural hematoma because of the increased time needed to obtain the study and the inability to use metallic objects that are needed to resuscitate patients with trauma (eg, most ventilators) in the scanning environment.

MRI can be a useful study to evaluate associated parenchymal brain injury and predict prognosis, but only after stabilizing and treating any life-threatening lesions. MRI is more sensitive for detecting nonhemorrhagic brain lesions, contusions, and diffuse axonal injury. [32]

An MRI is helpful in imaging chronic subdural hematoma when CT scans are difficult to interpret (eg, when suspecting an isodense hematoma). MRI may be particularly helpful in diagnosing bilateral chronic subdural hematoma because a midline shift may not be apparent on CT scan.


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