Cerebral contusions, subarachnoid haemorrhage and subdural hygromas

Case contributed by A.Prof Frank Gaillard

Presentation

Fall from a height.

Patient Data

Age: 80 years

CT obtained on admission (D0) demonstrates a right occipital scalp haematoma with no underlying fracture. Large bilateral frontal and temporal haemorrhagic contusions (contrecoup) with overlying traumatic subarachnoid haemorrhage. A small amount of subdural haemorrhage is also seen layering on the tentorium, particularly on the right. 

CT obtained the next day (D1, 24hrs) demonstrates the development of bilateral subdural hygromas larger on the left. Oedema is also more prominent around the hemorrhagic contusions. Blood is now seen redistributed over the convexity of the brain as well as refluxing into the ventricles, pooling in the occipital horns. 

CT obtained the next day (D2, 48 hrs) demonstrates the conituned evolution of haemorrhages and enlargement of hygromas. 

Movement degraded CT on day 4 again shows enlarging hygromas and resolving blood. 

Case Discussion

This case illustrates the evolution of closed head injury with blood in the subdural, subarachnoid and intraventricular compartments. Subdural hygromas also noted as are cerebral contusions. 

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Case information

rID: 55399
Case created: 4th Sep 2017
Last edited: 17th Sep 2017
Inclusion in quiz mode: Included

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