CT scan of the head showing a biconvex hyperdense lesion displacing the grey-white matter interface is seen in which of the following condition?
First, the core concept here is CT imaging findings of intracranial lesions. Hyperdense means the lesion is denser than surrounding tissue, like acute bleeding. Biconvex shape and displacement of grey-white matter interface are key clues.
Next, the correct answer is likely subdural hematoma. Subdural hematomas are typically biconvex (lens-shaped) and cause a "white on white" sign on CT when acute, displacing the grey-white interface. They form between the dura and arachnoid, often from bridging vein tears, common in trauma.
Now, the wrong options. Let's think about other conditions. Subarachnoid hemorrhage would show hyperdensity in sulci and cisterns, not a biconvex mass. Epidural hematoma is usually lens-shaped but doesn't cross suture lines, and it's more common in trauma with a lucid interval. Chronic subdural hematoma is hypodense and has a different appearance. Brain abscesses are hypoattenuating with ring enhancement, not hyperdense.
Clinical pearl: Remember that subdural hematomas are biconvex and can cross suture lines, while epidural are more lentiform and limited by suture lines. This is a high-yield point for imaging exams.
So the correct answer is subdural hematoma. The options need to be labeled accordingly. Let me check the formatting and make sure each section is correct.
**Core Concept**
This question tests the ability to identify CT imaging features of intracranial hemorrhage. A **biconvex hyperdense lesion** with **grey-white matter interface displacement** is a classic imaging finding in **acute subdural hematoma**, caused by venous bleeding between the dura and arachnoid mater.
**Why the Correct Answer is Right**
Acute **subdural hematoma** (SDH) appears as a **biconvex (lens-shaped) hyperdense** collection on non-contrast CT, reflecting acute blood. The **grey-white matter interface displacement** (also called "white on white" sign) occurs because the hematoma compresses the brain, pushing the hyperdense white matter against the hyperdense grey matter. SDHs are typically caused by **bridging vein tears** from head trauma, common in elderly patients or those with coagulopathy.
**Why Each Wrong Option is Incorrect**
**Option A:** *Subarachnoid hemorrhage* presents as hyperdensity in **cerebral sulci/cisterns**, not a biconvex mass.
**Option B:** *Epidural hematoma* is **lens-shaped** but **does not cross sutures** (limited by dural attachments), unlike SDH.
**Option C:** *Chronic subdural hematoma* is **hypodense** and may have a **crescent shape**, not hyperdense.
**Option D:** *Brain abscess* shows **hypodense center with ring enhancement**, not hyperdensity