Subarachnoid hemorrhage

Case contributed by Hani Makky Al Salam
Diagnosis certain

Presentation

25 year old male with history of assault presented with headache and decreased level of consciousness.

Patient Data

Age: 25 years
Gender: Male
ct

Bilateral curvilinear hyperdensities are noted in both cerebral hemispheres more pronounced on the parieto-occipital region more on the side, representing subarachnoid bleed. Thin 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 preserved. No hydrocephalus is seen. No herniation is noted.
Notice is made of bilateral subgaleal hematomas at both parieto-occipital regions. Bilateral parietal bone fractures.

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