Cerebral tumour haemorrhage
Metastatic melanoma of brain, and calvarium presents with fever, confusion and decreased GCS.
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Hyperdense focus 8 x 16 mm consistent with acute haemorrahge in right temporal metastasis. Significant vasogenic oedema in right parietotemporal region with effacement of sulci, lateral ventricle and midline shift of 7mm.
Uncal herniation with midbrain shift to left and asymmetry of quadrigeminal cistern.