Major head trauma

Case contributed by Dr Andrew Dixon

Presentation

Fall from roof onto head.

Patient Data

Age: 60 years
Gender: Male
CT

Extensive calvarial, skull base and facial fractures. Traumatic subarachnoid and intraventricular haemorrhage. Scattered petechial intraparenchymal haemorrhages including within the midbrain consistent with shearing injury. Cerebral oedema with loss of grey-white differentiation, on the left in particular, possibly due to dissection of the left ICA at the skull base due to fractures. There is a nice example of the 'white cerebellum sign' of cerebral oedema which is an extremely poor prognostic feature. This patient died shortly after. 

Case Discussion

A case of non-survivable head trauma with established diffuse cerebral oedema and petechial brainstem haemorrhages due to shearing injury (diffuse axonal injury). 

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Case information

rID: 32393
Case created: 25th Nov 2014
Last edited: 11th Oct 2017
Inclusion in quiz mode: Included

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