Bilateral frontal contusions with subdural hematoma and hemosinus

Case contributed by Dr Mostafa 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, representing a subdural hematoma of late subacute duration.

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

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

Minimal (6mm) subarachnoid hemorrhage is also noted at the interpeduncular cistern.

No midline shift.

No gross vascular anomalies identified.

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

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Case information

rID: 42144
Published: 12th Jan 2016
Last edited: 22nd Mar 2019
Inclusion in quiz mode: Included

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