Bilateral frontal contusions with subdural haematoma and hemosinus

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Head trauma.

Patient Data

Age: 30-year-old
Gender: Male

Right sided fronto-tempro-parietal extra-axial (likely subdural) collection is noted reaching 1 cm in thickness. It shows T1 and T2 high signal, probably representing a subdural haematoma of late sub acute duration.

Bilateral frontal cerebral contusions and small intracerebral haematomas are also seen showing late subacute duration, more sizable on the left side reaching 5.5 cm in maximum dimension. Perilesional oedema also noted.

Another tiny hemorrhagic cerebral foci are noted in the susceptibility images (SWI) are noted within both cerebral and cerebellar hemispheres notably the right temporal lobe as well as the right side of the Pons and mid brain suggesting microbleeds.

Minimal (6mm) sub-arachnoid haemorrhage is also noted at the interpeduncular cistern.

No midline shift.

No cervico-medullary junction abnormalities seen.

No gross vascular anomalies identified.

Right maxillary, frontal and sphenoid sinuses show lost aeration and harboring T1 high signals and thick mucosa suggesting hemo-sinuses.

 

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Case Information

rID: 42144
Case created: 7th Jan 2016
Last edited: 18th Jan 2016
Inclusion in quiz mode: Included

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