CT recognition of subcortical hematomas

Subcortical hematomas develop in brain trauma and less commonly in hypertensive intracerebral hemorrhage. Six cases are reported that exhibit a spectrum of computed tomographic (CT) findings in this entity. Pathologic correlates in four cases are presented. It is theorized that subcortical hematomas form in trauma secondary to shearing stresses in the brain. Differential movement of gray and white matter may disrupt cortical medullary vessels. Rupture of degenerative vessels at this junction may account for hypertensive hematomas.