Presentation
Decreased level of consciousness after a motor vehicle accident.
Patient Data
A fairly defined extra-axial epidural bi-convex (lentiform shaped) collection is seen related to the right frontal region. It exhibits a predominantly high attenuation value suggesting a recent epidural hematoma. It measures about 7.3 cm long and about 30 mm in its maximum thickness. It exerts a mass effect in form of effacement of the underlying cortical sulci, compression of right lateral ventricle frontal horn as well as minimal contra-lateral midline shift.
There are changes related to right frontal craniotomy bone flap with the evacuation of an underlying previously seen epidural hematoma which shows a significant regressive course regarding the amount and mass effect with the residual minimal heterogeneous collection as well as gas foci inside (pneumocephalus).
Minimal subgaleal thickening/ collection with small gas locules, subcutaneous drain in situ, and surgical sutures (post-operative changes).
Case Discussion
Typical appearance of an epidural hematoma with rapid surgical intervention resulting in good decompression.