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. 2020 Oct 20;63(3):417–430. doi: 10.1007/s00234-020-02564-z

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© The Author(s) 2020

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Fig. 6 — Case “BESS6.” 4 months old. a T2-w ax. b T1-w ax. c T2* ax. d T1-w after contrast (gadolinium was given by wish of the pediatrician). Anamnesis (not available for the neuro and non-neuroradiologists): macrocephaly. MRI findings: on the left, the T1-w hyperintense SDH (b and d) displaces the leptomeningeal vessels inward and away from the inner table. In comparison, BESS (curved white arrows) on the right (d) demonstrates interdigitating vasculature within them and is iso-attenuating to the cerebrospinal fluid (CSF) without mass effect. In this patient, the association between BESS and homogenous late subacute SDH left frontoparietal (a, b, and d; straight arrow) led twice to the wrong assumption of an pAHT within the group of non-neuroradiologists. All neuroradiologists correctly assumed BESS and ruled out pAHT. They based their diagnosis on the absence of avulsed and thrombosed cortical veins (see T2* (c) and SWI (not shown)) and the normal pattern of myelination as assessed by T1-w imaging (b)