Endgames Spot Diagnosis

Computed tomography findings in a confused patient

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5377 (Published 19 October 2016) Cite this as: BMJ 2016;355:i5377
  1. Joseph Dalby Sinnott, core surgical trainee1,
  2. David C Howlett, consultant radiologist2
  1. 1Department of Surgery, East Sussex Hospitals NHS Trust, Eastbourne, UK
  2. 2Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne, UK
  1. Correspondence to: J D Sinnott j.d.sinnott{at}gmail.com

A 75 year old woman was referred to the emergency department from her nursing home because of increasing confusion. She had a history of falls and was taking warfarin for atrial fibrillation (international normalised ratio 2.6). On examination the patient appeared confused but had no focal neurological deficit. She underwent cranial computed tomography (CT) (fig 1). What does this show?

Fig 1

Answer

The CT scan shows two subdural haematomas: one on the right (fig 2 …

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