Diffuse axonal injury and extra-axial bleed
30 year old victim of MVA presented with GCS of 3
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Large left-sided extra-axial bleed is demonstrated associated with underlying comminuted fracture of the left frontal bone extending into ipsilateral sphenoid bone i.e base of the skull. Large left-sided subgaleal hematoma is also seen. Multiple scattered tiny hyperdensities involving mainly both frontal lobes at the grey-white junction and a focal hemorrhage within the right side of the splenium of the corpus callosum are features of at least grade 2 diffuse axonal injury (shear injury). Trace subarachnoid blood at the interpeduncular cistern. A hyperdensity is also demonstrated at the posterior horn of the left lateral ventricle likely representing intraventricular hemorrhage. No hydrocephalus is seen. No significant midline shift is demonstrated. No tentorial herniation is seen. Left sphenoid hemosinus is noted.
Petechial hemorrhages within the frontal grey-white interface bilaterally and within the right side of the splenium of the corpus callosum consistent with at least grade 2 diffuse axonal injury (shear injury). Additional findings include left frontal extra-axial hemorrhage, trace subarachnoid blood at the interpeduncular cistern and hemorrhage in the left lateral ventricle.