Extradural hematoma - swirl sign

Case contributed by Henry Knipe

Presentation

Fall with headstrike. GCS 5.

Patient Data

Age: 30 years
Gender: Male

Large right cerebral convexity extradural hematoma resulting in leftward midline shift, uncal herniation and brainstem compression. Heterogeneous appearance (swirl sign) suggestive of active bleeding. Early hydrocephalus and generalized cerebral edema. 

Case Discussion

There was also an undisplaced fracture through the squamous temporal bone (not well seen on thick slices). The patient went for urgent craniotomy and evacuation. 

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