Inferior frontal contusion increased over 24 hours

Case contributed by Dr Andrew Dixon

Presentation

Fell onto train tracks.

Patient Data

Age: 35 years
Gender: Female

Small right parieto-occipital scalp hematoma. Subtle small acute hemorrhage within the right inferior frontal lobe (gyrus rectus) which is best seen on the coronal and sagittal reformats. The inferior frontal lobe is an important check area on CT brain as contusion in this area can be easily missed on axial images due to beam hardening and partial voluming at the floor of the anterior cranial fossa.

CT

24 hours later

The right inferior frontal lobe intraparenchymal hemorrhage has increased significantly in size, as has the surrounding edema. It is common for intraparenchymal hemorrhages to become more conspicuous over the first 24 hours due to the development of surrounding edema.  

Case Discussion

This case emphasizes two things:

  1. the importance of looking specifically at the inferior frontal lobes on trauma CT brain for subtle contusions, and particularly the coronal and sagittal images
  2. that 24 hours CT brain is useful when intraparenchymal hemorrhage is suspected on initial CT as the hemorrhage and edema often become more pronounced
PlayAdd to Share

Case information

rID: 70968
Published: 14th Sep 2019
Last edited: 24th Jun 2020
System: Trauma
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.