Subarachnoid haemorrhage - traumatic

Case contributed by Dr Aditya Shetty

Presentation

Fall from a height. Injury to the head.

Patient Data

Age: young adult
Gender: Male

Plain axial CT scan reveals areas of blood density noted in the subarachnoid spaces involving the sulcal spaces, Sylvian fissures and all basal cisterns bilaterally.

This is suggestive of a subarachnoid haemorrhage.

Another area of blood density noted in the left inferior frontal region suggestive of a contusion.

This is a coup-contrecoup injury.

Bone window reveals a fracture of the right parieto-occiptal bone with a subgaleal haematoma surrounding it. Subgaleal haematoma also noted in the left temporal region.

Case Discussion

The differential diagnosis for high density in the subarachnoid space beside subarachnoid haemorrhage (most common) is:

  1. Pyogenic leptomeningitis
  2. Leakage of intravenous contrast into the basilar cisterns
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Case information

rID: 25710
Published: 4th Nov 2013
Last edited: 9th Jul 2018
Inclusion in quiz mode: Included

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