Presentation
High-velocity motor vehicle accident, the patient rolled his vehicle. He was found to be intoxicated at the time of presentation and imaging.
Patient Data
There is a high vertex, left subgaleal hematoma and soft tissue swelling corresponding to the site of blunt impact. The cranium and visualized facial bones are intact. There are scattered scalp and facial soft tissue punctate superficial densities likely representing a combination of dermal calcification and foreign bodies/debris.
There is acute subarachnoid hemorrhage with hyperdense blood interdigitating along the anterior interhemispheric fissure, best appreciated on the sagittal reconstructed images.
There is an acute right tentorial cerebelli subdural hematoma.
There are no other post-traumatic intracranial abnormalities present.
Case Discussion
Features consistent with a coup-contrecoup injury pattern. There is left occipital impact with anterior interhemispheric subarachnoid hemorrhage and an acute right tentorial cerebelli subdural hematoma.
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