Presentation
Unresponsive following a motorcycle accident.
Patient Data
There is diffuse loss of gray-white matter differentiation involving both cerebral hemispheres, concerning for anoxic brain injury. There is associated effacement of the lateral ventricles and a leftward midline shift.
There is diffuse subarachnoid hemorrhage within the sulci of both cerebral hemispheres, most pronounced in the right cerebral hemisphere. There is also intraventricular hemorrhage within the right lateral ventricle and third ventricle.
There is a left temporal bone fracture extending through the left mastoid and left TMJ.
There is blood products in the left mastoid air cells. There is a trace right mastoid effusion.
Case Discussion
This is a case featuring multiple findings of a head trauma, including multicompartment hemorrhage, diffuse anoxic brain injury, and a temporal bone fracture.
A Tc-99m brain death study was performed which confirmed the absence of cerebral blood flow.
Co-author:
Ekaterina Sazon