Contre coup injury with cerebral hemorrhagic contusion

Case contributed by Sajoscha A. Sorrentino


Patient was riding her bicycle when she was hit by a car and smashed the windshield with the back of her head.

Patient Data

Age: 20 years
Gender: Female

Initial CT showed no skull fracture, but revealed fronto-basal bleeding as a contre coup injury.

Brain (4 days later)


Four days after the accident you can clearly see the fronto-basal and right-temporal bleeding. There is also blood on the right tentorium.

Brain (10 days later)


Ten days after the accident the fronto-basal and right-temporal bleeding has still the same size.

As a normal variant you can see a cavum septum pellucidum with cavum vergae.

Case Discussion

The location of the bleeding is typical, as it often shows in places of asperty of the inner skull surface, i.e. foremost frontobase and temporal pole.

Small contusion near the skull base can easily be overseen on CT scans due to partial volume effects.

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