Findings
- Sequelae of ballistic injury to the head with acute comminuted fractures of the frontal bone bilaterally, bilateral parietal bones, and right occipital bone with widening of the right lambdoid suture. Numerous intracranial ballistic fragments extend from the left anterior frontal lobe across midline to the right temporoparietal region
- Extensive cerebral edema with diffuse sulcal effacement and downward transtentorial herniation with partial effacement of the basal cisterns. A small portion of the left frontal lobe herniates through a bony defect at the coronal suture
- Pneumocephalus and hemorrhage along the ballistic trajectory. Scattered extra-axial hemorrhage overlying the right greater than left cerebral convexities. Hemorrhage in the right lateral ventricle without hydrocephalus
- Hypoattenuation throughout the dural venous sinuses may relate to acute anemia
Diagnosis
Penetrating head injury
Sample Report
Sequelae of ballistic injury to the head with acute comminuted, displaced fractures of the bilateral frontal bones, bilateral parietal bones, and right occipital bone with widening of the right lambdoid suture. Numerous intracranial ballistic fragments extend from the left anterior frontal lobe across midline to the right temporoparietal region.
Extensive cerebral edema with diffuse sulcal effacement and downward transtentorial herniation with partial effacement of the basal cisterns. A small portion of the left frontal lobe herniates through a bony defect at the coronal suture.
Pneumocephalus and hemorrhage along the ballistic trajectory. Scattered extra-axial hemorrhage overlying the right greater than left cerebral convexities measuring up to x mm in thickness. Hemorrhage in the right lateral ventricle without hydrocephalus.
Hypoattenuation throughout the dural venous sinuses may relate to acute anemia.
Discussion