Presentation
High speed MBA. Closed head injury.
Patient Data
Brain:
Bilateral frontoparietal parafalcine subdural hematomas, measuring 10 mm in thickness on the left and 6 mm on the right. Small left cerebral convexity subdural hematoma measuring 3 mm in thickness. There is likely also a small right frontal convexity subdural hematoma measuring 4 mm in thickness. Moderate volume of intraventricular blood within the occipital horn of the left lateral ventricle.
Normal ventricular and sulcal pattern. No midline shift. No uncal or tonsillar herniation. The basal cisterns are not effaced.
Small areas of parenchymal hypoattenuation in the right superior frontal lobe, left internal capsule (posterior limb), right sublentiform nucleus/cerebral peduncle, and right temporal lobe. It is possible these represent non-hemorrhagic contusions. Another considered in multifocal infarcts.
No calvarial fracture. The mastoid air cells are clear.
Conclusion:
1. Bilateral subdural hematomas as described.
2. Intraventricular blood within the occipital horn of the left lateral ventricle.
3. Impression of multifocal areas of parenchymal hypoattenuation in both cerebral hemispheres, which could reflect non-hemorrhagic contusions or multifocal infarcts.
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