Presentation
Head trauma following a road traffic accident.
Patient Data
Age: 5 years
Gender: Female
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extra-axial hyperdense fluid collection along the left fronto-temporo-parietal region, in keeping with an acute subdural hemorrhage.
there is a mass effect with left-to-right midline shift without subfalcine herniation
mild hypodensity of the basal ganglia
no fractures on bone window
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- CT follow-up shows spontaneous resorption of the subdural hemorrhage
- onset of a mild diffuse cerebral edema with a slight hyperdense cerebellum
- the dural venous sinuses appear hypodense, in keeping with anemia
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- CT follow-up shows marked diffuse cerebral edema
- mass effect with left-to-right midline shift
- the cerebellum paradoxically appears dense
- the superficial cortical veins are hyperdense, with a dense vein sign, due to acute cortical venous thrombosis
- marked effacement of the perimesencephalic cisterns
- the ventral pons appears flattened against the clivus (central herniation)
Case Discussion
This case illustrates a white cerebellum sign following mild head trauma. there were no bone fractures, only a mild subdural hemorrhage in the initial CT. Brain death was confirmed 3 days following the initial trauma.
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