What is the prognostic value of swirl sign?
It is a disastrous sign, indicating active bleeding and predicting the expansion of haematoma and bad outcomes.
Non-contrast CT shows:
massive Right parietal lentiform well-defined biconvex extra-axial hyperdense collection is noted just anterior to the entry-point of the ventricular catheter, measuring about 12 × 12 × 6 cm, with severe mass effects, midline shift, subfalcine, transtentorial, uncal and tonsillar herniation signs
swirl sign is noted (an isodense to hypodense area represents a hyperacute component indicating unclotted blood/active bleeding inside the hyperdensity that represents an acute component and indicates clotted blood)
the findings correlate with hyperacute epidural haematoma
subfalcine, uncal and cerebellar tonsillar herniation