Presentation
Fall from roof onto head.
Patient Data
Extensive calvarial, skull base and facial fractures. Traumatic subarachnoid and intraventricular hemorrhage. Scattered petechial intraparenchymal hemorrhages including within the midbrain consistent with shearing injury. Cerebral edema with loss of grey-white differentiation, on the left in particular, possibly due to dissection of the left ICA at the skull base due to fractures. There is a nice example of the 'white cerebellum sign' of cerebral edema which is an extremely poor prognostic feature. This patient died shortly after.
Case Discussion
A case of non-survivable head trauma with established diffuse cerebral edema and petechial brainstem hemorrhages due to shearing injury (diffuse axonal injury).
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