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Age: 27

Sex: Male

Indication: MVC

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Case #6


Findings

  • Multifocal acute parenchymal hemorrhage involving the subcortical white matter of the bilateral frontal and parietal and right temporal lobes, left basal ganglia, and right thalamus
  • Acute subdural hematoma layering along the right aspect of the posterior falx tracking along the right tentorial leaflet
  • Small amount of acute intraventricular hemorrhage layering in the occipital horn of the left lateral ventricle
  • Bilateral cerebral sulcal crowding without effacement of the basal cisterns
  • No evidence of acute fracture
  • Left anterior parietal approach intracranial pressure monitor
  • Right parietal scalp and high posterior left parietal scalp hematomas
  • Punctate radiodensity in the right postauricular soft tissues, possibly a retained foreign body


Diagnosis

  • Diffuse axonal injury (DAI)
  • Subdural and intraventricular hemorrhage

Sample Report

Multifocal acute parenchymal hemorrhage involving the subcortical white matter of the bilateral frontal and parietal and right temporal lobes, left basal ganglia, and right thalamus. This appearance raises concern for diffuse axonal injury (DAI).

Acute subdural hematoma layering along the right aspect of the posterior falx and tracking along the right tentorial leaflet measuring up to 3 mm in thickness.

Small amount of acute intraventricular hemorrhage in the occipital horn of the left lateral ventricle.

Likely mild cerebral edema contributing to bilateral sulcal crowding without midline shift or evidence of herniation.

Punctate radiodensity in the right postauricular soft tissues may represent a retained foreign body. Recommend correlation with direct inspection.


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Images

Blue arrow: thin acute subdural hematoma along the right aspect of the posterior falx. Red arrow: small amount of intraventricular hemorrhage layering in the occipital horn of the left lateral ventricle.



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