25 year old male with history of assault presented with headache and decreased level of consciousness.
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SAH, SDH and skull fracture.
Bilateral curvilinear hyperdensities are noted in both cerebral hemispheres more pronounce on the priato-occipital region more on the side as well as at the tentorium cerebelli, representing subarachnoid bleed. Extra-axial hyperdensity seen along the surface of the right cerebral hemisphere, representing subdural hemorrhage. Multiple tiny hyperdensities are noted in both cerebral hemispheres more pronounced at the inferior portion of the frontal lobes mainly on the right side representing brain contusions. Tiny hyperintensity is noted at the brain stem likely to represent a contusion.
Note is made of moderate brain edema. However no significant midline shift is demonstrated. The ventricular system is maintained. No hydrocephalus is seen. No herniation is noted.
Notice is made of bilateral subglial hematomas at both parito-occipital regions. Bilateral parital bone fractures.