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Traumatic hemorrhage

Case contributed by Jeremy Jones
Diagnosis certain

Presentation

Fall during a street football game. Hit head on ground (concrete). LOC for 15-20 minutes. Right hemotympanum. GCS 12.

ct

Thin right-sided acute subdural hematoma with subarachnoid component. Note moderate midline shift and compression of the anterior horn on the right. Right frontal contusion bleedings. Contra-coup subarachnoid bleeding in the right frontal region. 

Case Discussion

Extra-axial blood in the subdural space (right parietal, falx cerebri and tentorium)

Traumatic subarachnoid blood in the right frontal region and in a contra coup location in the left parietal region.

Right frontal contusions.

Significant mass effect with effacement of the ipsilateral lateral ventricle but no contralateral hydrocephalus.  Midline shift with subfalcine herniation.

Being transferred to our local neurosurgical center now.

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