Enhancing subdural effusions mimicking acute subdural hematomas following angiography and endovascular procedures: report of 2 cases

Abstract

Hyperdense enhancing subdural effusion due to contrast extravasation has been recently described as a potential mimicker of acute subdural hematoma following a percutaneous coronary procedure. Herein, the authors report on 2 patients who presented with subarachnoid hemorrhage from ruptured cerebral aneurysms and who developed enhancing subdural effusions mimicking acute subdural hematomas after angiography and endovascular coil placement. In 1 case, the subdural effusions completely cleared but recurred after a second angiography. CT attenuation values higher than expected for blood, as well as the evolution of the effusions and density over time, allowed for differentiation of enhancing subdural effusions from acute subdural hematomas.

Keywords: HU = Hounsfield unit(s); aneurysm; mimic; rupture; subarachnoid hemorrhage; subdural effusion; subdural hematoma; trauma; vascular disorders.