OBJECTIVE Imaging follow-up for acute intracranial hemorrhage has followed the same protocols despite differences in clinical progression and outcome associated with bleed in different compartments. We evaluated isolated, small parafalcine and paratentorial subdural hemorrhages to determine the necessity of routine imaging follow up. METHODS We conducted a retrospective review of all patients presenting to the Emergency Department who were found to have an isolated parafalcine and/or paratentorial subdural hemorrhage, and obtained follow up imaging over the course of 3 years. Subsequent imaging was reviewed to assess for changes in hemorrhage size and the average number of studies performed; clinical data was reviewed for changes in patient status and any intervention if performed. RESULTS 95 patients were identified with isolated parafalcine and/or paratentorial hemorrhage that were evaluated with multiple follow-up imaging studies. The average initial subdural hemorrhage thickness was 3.5 mm, with all smaller than 1 cm. The average number of subsequent imaging studies performed was 2.7. All patients received follow up imaging despite remaining neurologically stable. 96 % of the patients had stable to decreased size off hemorrhage on follow up exams. The remaining 4% had a slight increase on the second imaging study but, stabilized without any intervention. Anticoagulation use had no correlation with increase on subsequent imaging. CONCLUSION Small isolated parafalcine and/or paratentorial hemorrhage in a neurologically stable patient and absence of anticoagulation does not require scheduled routine follow-up imaging.

中文翻译：

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常规随访成像对小面积黄斑素和/或幕旁出血患者的效用

目的 急性颅内出血的影像学随访遵循相同的方案，尽管临床进展和与不同隔室出血相关的结果存在差异。我们评估了孤立的、小的镰刀旁和幕旁硬膜下出血，以确定常规影像学随访的必要性。方法 我们对所有到急诊科就诊的患者进行了回顾性审查，这些患者被发现有孤立的镰刀旁和/或幕旁硬膜下出血，并在 3 年内获得了随访影像。随后的影像学检查以评估出血量的变化和进行的平均研究次数；审查临床数据以了解患者状态的变化以及任何干预措施。结果 95 名患者被鉴定为孤立性镰刀旁炎和/或幕旁出血，并通过多项后续影像学研究进行评估。平均初始硬膜下出血厚度为 3.5 mm，均小于 1 cm。进行的后续成像研究的平均次数为 2.7。尽管神经系统保持稳定，但所有患者都接受了后续成像。96% 的患者在随访检查中出血量稳定或减少。其余 4% 在第二次成像研究中略有增加，但在没有任何干预的情况下稳定下来。抗凝的使用与后续影像学检查的增加没有相关性。结论 神经系统稳定且未接受抗凝治疗的患者出现小的孤立性镰刀旁炎和/或幕旁出血不需要定期的常规随访成像。