engleski

Subdural Hematoma vs. Brain Tumor: the importance of contrast application in the brain examination performed by the computerized tomography

Aim: to give new evidences for proving of the importance of the contrast media application in the brain examination performed by the computerized tomography. Case Presentation: during a routine native examination of brain preformed with the computerized tomography of a patient suffering from the chronic headache and negating the experience of the previous trauma, the extensive edema of the brain tissue in the left frontal part of his brain with the contralateral displacement of the medio- sagittal structures was described, which according to its characteristics corresponded to a brain tumor and in the accordance with the established practice the intravenous contrast media application was performed. Subsequently there was no opacification of the mass, which would be typical for a tumor, while at the same time the extra axial formation which was previously isodense with the surrounding brain tissue was visualized, which suggested a diagnosis of the sub-acute subdural hematoma of an no traumatic cause. This was further confirmed after the neurosurgical operation during which craniotomy was performed in order to evacuate the mentioned hematoma. Conclusion: the above presented case report shows that the native brain examination performed by the computerized tomography is not enough for providing a final diagnosis, but could even point the radiologist in the wrong direction, which is why the contrast media application should be implemented in all unclear cases despite its potentially advers effects such as allergic reactions.

brain tumor ; sub-acute subdural hematoma (SASDH) ; computerized tomography (CT) ; contrast media ; headache

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