Presentation
Post-traumatic confusion.
Patient Data
Multiple brain foci of altered signal in grey-white matter junction at the left fronto-parietal region, bilateral medial temporal lobes and left cerebellar hemisphere. They show high T2 and FLAIR signal, blooming on SWI and diffusion restriction.
The medial right temporal lobe shows high signal intensity on T2 and FLAIR with diffusion restriction, suggestive of contusion.
Case Discussion
SWI is the most sensitive sequence to detect cerebral microbleeds. Diffuse axonal injury has a predilection to grey-white matter junction. In this case, it is considered stage I as it spares the corpus callosum and brainstem.
In the setting of trauma, the medial right temporal lobe changes are in keeping with cortical contusion, as it involves the cortex rather than the grey-white matter junction.
Unable to process the form. Check for errors and try again.