Diffuse axonal injury

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

High-speed MVA.

Patient Data

Age: 25 years
Gender: Male

CT Brain

ct

Multiple small foci of intraparenchymal hemorrhage scattered throughout both brain hemispheres and, in this clinical scenario, consistent with severe traumatic brain injuries related to shearing forces. Bilateral subarachnoid hemorrhage coating some of the cerebral gyri. The grey-white matter differentiation is preserved, no evidence of acute infarcts. Ventricular system and cisternal spaces appear normal. No skull fracture. The mastoid air cells are clear. No facial bone fractures. Orbits have normal appearances. The paranasal sinuses are clear and aerated. Within the right temporal soft tissues, there are multiple radiopaque foreign bodies likely related to a laceration.

Displaced fracture of the left lateral mass of C1 partially imaged in this study and has been further assessed with the cervical spine images (not shown). 

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