Tight Sylvian cisterns associated with hyperdense areas mimicking subarachnoid hemorrhage on computed tomography--four case reports.

S Shimizu, M Endo, S Kan, T Kitahara, T Ohwada, K Fujii

Journal: Neurologia medico-chirurgica 2002;41(11):536-40

PMID: 11758705

Free Full Text on J-STAGE, Japan Science and Technology Information Aggregator, Electronic View on PubMed

Abstract

Four patients with supratentorial mass lesions (two chronic subdural hematomas, one acute epidural hematoma, and one acute subdural hematoma) showed hyperdense sylvian cisterns on computed tomography (CT). Association of subarachnoid hemorrhage was suspected initially, but was excluded by intraoperative observation or postoperative lumbar puncture. CT showed disappearance of the hyperdense areas just after evacuation of the mass lesions. The hyperdense areas are probably a result of the partial volume phenomenon or concentrations of calcium deposits rather than abnormally high hematocrit levels, which were not found in these patients.

Address: Department of Critical Care and Emergency Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

DOI: 10.2176/nmc.41.536

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MeSH Terms: Accidental Falls, Accidents, Traffic, Adult, Aged, Cerebral Aqueduct, Chronic Disease, Coma, Craniotomy, Diagnosis, Differential, Head Injuries, Closed, Hematoma, Humans, Male, Subarachnoid Hemorrhage, Temporal Lobe, Tomography, X-Ray Computed, Wounds, Nonpenetrating