Subdural haematoma and Duret haemorrhage
Sudden onset of unresponsiveness. GCS 5.
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Large acute convexity subdural haematoma extending along the left cerebral hemisphere with significant mass effect over the brain parenchyma, which is characterised by sulcal effacement, significant rightward midline shift (2.5 cm), and subfalcine and uncal herniation. Third and lateral ventricles are compressed and distorted with dilatation of the right temporal horn in keeping with hydrocephalus. Small amount of intraventricular blood in the right temporal horn. There is a haemorrhagic focus on the right side of the pons/pontomesencephalic junction in keeping with a Duret haemorrhage. Grey-white matter differentiation is preserved. No evidence of acute infarct. Imaged orbits, paranasal sinuses, and calvarium are unremarkable.