Presentation
Fall from skateboard. Hit occiput.
Patient Data
Left inferior frontal lobe intraparenchymal contusions best appreciated on the coronal and sagittal images with trace extra-axial hemorrhage in association. A few tiny right inferior frontal lobe contusions are also present. Left occipito-temporal scalp hematoma and underlying left lambdoid suture fracture diastasis with the fracture continuing into the left petrous temporal bone where hemorrhage is seen in the mastoid air cells and middle ear cavity. The ossicular chain and otic capsule remain intact. Several locules of gas from the temporal bone fracture have tracked into the left transverse sinus.
Case Discussion
The inferior frontal lobes are an important check area on trauma CT brain as intraparenchymal contusions here are often difficult to appreciate on axial images. It is important to review the coronal and sagittal images carefully for subtle hemorrhage.
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