Presentation
Inpatient with left-sided weakness (?stroke). Fall tonight - MET call for decreased GCS ?ICH.
Patient Data
There is a 2.5 mm thick extra-axial collection of high-density material along the right tentorium cerebelli in keeping with subdural hematoma.
No evidence of intra-axial hemorrhage or acute large cortical territorial infarction. No skull fracture. There is extensive opacification of the right maxillary sinus with high-density material in keeping with hematoma. Secretions in the nasal cavity and nasopharynx are shown.
There is a nasal bone fracture.
Case Discussion
This case demonstrates the importance of reviewing all the images available and the benefit of multiplanar imaging of the brain in the setting of trauma. On axial plane images, the subdural hematoma is subtle but on is plainly evident on both the coronal and sagittal planes.
Acknowledgement: Dr Jan Gerstenmaier.
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