Cerebral hemorrhagic contusions and cervical spine fractures

Case contributed by Dr Heather Pascoe

Presentation

Head injury and seizure

Patient Data

Age: 55
Gender: Male
CT

Brain and Cervical spine

Brain

  • Multiple small bilateral inferior frontal hemorrhagic contusions.
  • Small volume associated traumatic subarachnoid.
  • Undisplaced right anterior frontal calvarial fracture extending superiorly through the sagittal suture to the contralateral side near the vertex. Associated small to moderate scalp hematoma overlying the vertex.

C-spine

  • Minimally displaced fracture of the left C4-C7 transverse processes.
  • The C6 fracture is markedly comminuted and involves the left C6 superior and inferior facets and articular pillar, with involvement of the left C6 foreman transversarium.
  • Fractures of the posterior arches of C6 bilaterally.
  • Anterior compression fracture of the C7 vertebral body.
  • Minimally displaced C5 spinous process fracture.
  • Associated widening/subluxation of the C6/7 disc space and bilateral C6/7 facet joints.

Case Discussion

Cerebral hemorrhagic contusions are a type of intracranial hemorrhage that occur secondary to trauma. They occur due to the brain coming to a sudden stop against the skull. They can occur in the brain directly beneath the site of impact (Coup) or on the opposite side to the impact (Contrecoup). Contrecoup injuries are usually more severe that coup injuries. They most commonly occur in the anterior inferior frontal and temporal lobes, where the brain rests on the ridged bony floor of the anterior and middle cranial fossae respectively. Small contusions near the skull base can be difficult to identify due to partial voluming and coronal and sagittal reformats are required.

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Case information

rID: 32865
Published: 12th Feb 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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