Subdural haemorrhage - acute with active bleeding
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CT of the brain demonstrates a large acute subdural haemorrhage with associated extensive cerebral contusions and a large scalp haematoma on the left, in keeping with a coup-contrecoup injury pattern.
CTA demonstrates a globular blush of contrast representing active extravasation of blood into the subdural haemorrhage.
It is always important to remember that CT is a snapshot of a potentially dynamic process, and the size of a haemorrhage at the time of the scan does not mean that it will not continue to enlarge. Presence of a spot sign in parenchymal haemorrhages has been well described, however, identical findings will be seen anywhere that active bleeding is occurring.