Male, 68 years old, with history of CML in blast phase, now in remission, asymptomatic, with new dural thickening seen on sinus CT. A thin subdural collection is evident along nearly the entirety of the right cerebral hemisphere and to a lesser degree along the left frontal lobe demonstrating heterogeneous T1 hyperintensity, T2 hypointensity and susceptibility effect compatible with hemorrhage. The collection measures at most up to 5 mm in thickness and exerts mild regional mass effect with slight effacement of the adjacent sulci, and mild generalized mass effect with approximately 4 mm midline shift to the left.There may be minimal associated dural enhancement, likely reactive to the hemorrhage, but this is difficult to discern from the intrinsic T1 hyperintensity of the collection. No evidence to suggest an infiltrative dural process is seen.Minimal scattered ill-defined T2 hyperintense foci are seen within the bilateral cerebral hemispheres, a nonspecific finding. No evidence of restricted diffusion is seen. No pathologic parenchymal enhancement or parenchymal edema is suspected. The ventricles are within normal limits for size, though the right lateral ventricle is slightly smaller than the left at the level of the atria which could represent the mild generalized mass effect indicated above.Marrow signal of the calvarium is mildly heterogeneous which can be seen in anemia and chronic disease in general. No aggressive appearing or frankly destructive osseous lesions are demonstrated.
A thin holohemispheric subdural hematoma is evident along the right cerebrum, with a small subdural hematoma also seen along the left frontal lobe. At most, the right-sided collection measures up to 5 mm in thickness, inducing mild regional and generalized mass effect.