Presentation
Known sickle cell anaemia. New onset bilateral headache with no focal neurology.
Patient Data
Normal brain parenchyma without evidence of ischaemic or haemorrhagic stroke. There is perhaps slight widening of parietal diploe bilaterally and slight increase in density, but it is difficult to call this abnormal prospectively. A subsequent CT angiogram was normal.
One day later, the patient develops bilateral parietal swelling without trauma. Ultrasound demonstrates bilateral parietal subgaleal haematomas.
Parietal diploic signal is very abnormal and there are bilateral external subperiosteal haematomas. These findings are consistent with sickle cell crisis and haemorrhage.
The brain and CSF spaces are normal.
Case Discussion
A very unusual case of sickle cell crisis presenting as headache and subsequently developing bilateral parietal subperiosteal haematomas.
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