acute_isodense_subdural_hematoma [Neurosurgery Wiki]

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In Lee’s study of 351 patients with [[acute subdural hematoma]] SDH, the [[subdural hematoma]] appeared hyperdense in 98.6 % of cases, isodense in 1.1 %, and hypodense in 0.3 % of cases 
((Lee KS, Bae WK, Bae HG, Doh JW, Yun IG. The computed tomographic attenuation and the age of subdural hematomas. J Korean Med Sci. 1997 Aug;12(4):353-9. doi: 10.3346/jkms.1997.12.4.353. PMID: 9288636; PMCID: PMC3054217.)).
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In a small proportion of cases, an acute SDH may appear [[isodense]] or even [[hypodense]] compared with the adjacent [[parenchyma]]. This situation is encountered in cases of [[anemia]], [[disseminated intravascular coagulation]], or if the hematoma is diluted with [[cerebrospinal fluid]]
((Deb S, Bhaumik S, Pal H. Isodense acute subdural haematoma in anaemic patients. Neurol India. 2000 Sep;48(3):298-9. PMID: 11184455.)).
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A hyperdense subdural component was present in all acute subdural hematomas in anemic patients. Therefore, anemia alone is not a sufficient explanation for a homogenous low-density acute subdural hematoma
((Duy L, Badeeb A, Duy W, Alqahtani E, Champion W, Kim DH, Martin D, Vartanians V, Coffin P, Small JE. CT Attenuation of Acute Subdural Hematomas in Patients with Anemia. J Neuroimaging. 2019 Jul;29(4):536-539. doi: 10.1111/jon.12608. Epub 2019 Feb 16. PMID: 30771278.))