Diffuse axonal injury and extra-axial bleed

Case contributed by Dr Hani Salam

Presentation

30 year old victim of MVA presented with GCS of 3

Patient Data

Age: 30
Gender: Male
Modality: CT

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 haemorrhage 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.

Case Discussion

Petechial haemorrhages 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 haemorrhage, trace subarachnoid blood at the interpeduncular cistern and haemorrhage in the left lateral ventricle.

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Case Information

rID: 10314
Case created: 2nd Aug 2010
Last edited: 7th Dec 2015
Inclusion in quiz mode: Included

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