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The "hypernormal" CT scan in dementia

Bilateral isodense subdural hematomas

Department of Neurology, University of North Carolina School of Medicine and the North Carolina Memorial Hospital, Chapel Hill, NC.

Enlarged ventricles and prominent sulci are common findings on computed tomography (CT) in elderly demented patients. Three such patients were found to have small, symmetric ventricles and minimal sulci on tomography; these CT scans were considered "hypernormal" for the patients' ages and clinical syndromes. Bilateral isodense subdural hematomas were subsequently diagnosed by isotope brain scans in two cases and by angiography in the third. A "hypernormal" CT scan in an elderly demented patient suggests the possibility of bilateral isodense subdural hematomas, and requires further evaluation with isotope brain scan and, if necessary, angiography.

Address requestsfor reprints to Dr. Jacobson, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC 27514.

Accepted for publication April 24, 1979.