Posterior cerebral artery territory infarct due to subdural haematoma and uncal herniation

Case contributed by Dr Craig Hacking

Presentation

Found GCS 4.

Patient Data

Age: 55 years
Gender: Male

There is a 6mm left convexity acute subdural haematoma with extension along the tentorium cerebelli and falx. Evidence of raised intracranial pressure, with diffuse loss of hemispheric sulci bilaterally, compression of the left lateral and third ventricles, 5mm rightward midline shift and obliteration of the basal cisterns with transtentorial herniation and compression of the midbrain. There is loss of grey-white matter differentiation within the left occipital and temporal lobes, consistent with acute infarction of the left PCA.

Conclusion:

Acute left subdural haematoma with evidence of severely raised intracranial pressure and acute left PCA territory infarct.

Case Discussion

Great case for the signs of raised ICP and the complication of PCA infarct, where the PCA is compressed by uncal herniation across the tent.

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Case information

rID: 40106
Case created: 8th Oct 2015
Last edited: 14th Sep 2017
Inclusion in quiz mode: Included

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