Presentation
Motor vehicle collision presented with GCS of 3
Patient Data
Large left-sided extra-axial bleed is demonstrated associated with underlying comminuted fracture of the left frontal bone extending into ipsilateral sphenoid bone i.e. base of the skull fracture. Large left-sided subgaleal haematoma is also seen.
Multiple scattered tiny hyperdensities involving mainly both frontal lobes at the grey-white junction and a focal haemorrhage within the right side of the splenium of the corpus callosum are features of at least grade 2 diffuse axonal injury (shear injury). Trace subarachnoid blood at the interpeduncular cistern. A hyperdensity is also demonstrated at the posterior horn of the left lateral ventricle likely representing intraventricular haemorrhage. No hydrocephalus is seen. No significant midline shift is demonstrated. No tentorial herniation is seen. Partially-opacified left sphenoid haemosinus is noted.
Case Discussion
Petechial haemorrhages within the frontal grey-white interface bilaterally and within the right side of the splenium of the corpus callosum consistent with at least grade 2 diffuse axonal injury (shear injury).
Additional findings include left frontal extra-axial haemorrhage, trace subarachnoid blood at the interpeduncular cistern and haemorrhage in the left lateral ventricle.
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