Intraventricular bleed with skull base fracture

Case contributed by Hani M. Al Salam
Diagnosis certain

Presentation

Victim of MVA presented with GCS of 10

Patient Data

Age: 25 years
Gender: Male

Notice is made of intraventricular haemorrhage without hydrocephalus. Multiple contusions are demonstrated mainly at the right cerebral hemisphere.

Right-sided frontal bone mildly displaced fracture associated with a small adjacent extra-axial bleed is seen. The fracture line is extending through the right orbital roof and to the base of the skull. Associated right periorbital haematoma is seen. Another calvarial fracture is noted at the left frontal bone which is undisplaced. However, the fracture line is also extending into the left orbital roof to the base of the skull.

Mild brain oedema is seen. No herniation is demonstrated. No significant midline shift is seen.

Haemosinus is seen with fluid level in the right maxillary as well as the sphenoid sinuses.

Right parietal subcutaneous laceration is seen extending into the calvarial surface. Left frontal subgaleal haematoma is seen with multiple air locules and multiple tiny hyperdensities likely representing foreign bodies.

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