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Trauma and intraparenchymal cerebral hemorrhage

Case contributed by Peter Mitchell
Diagnosis certain

Presentation

Trauma - fall and loss of consciousness requiring intubation.

Patient Data

Age: 60 years
Gender: Female

There is an acute intracerebral hemorrhage in the right temporal lobe measuring 3.7 x 2.6 cm with surrounding vasogenic edema.

There is also a 1.2 by 0.7 cm focus of acute intracerebral hemorrhage in the left temporoparietal lobe, surrounded by vasogenic edema.

Acute right hemispheric extra-axial hemorrhage, with a maximal depth of 5 mm, represents subdural hemorrhage.

There is significant associated mass effect, with diffuse cerebral sulcal effacement, leftward midline shift of 1.3 cm and bilateral cerebellar tonsillar herniation.

There is partial effacement of the right lateral ventricle and complete effacement of the third ventricle. The temporal horn of the left lateral ventricle is prominent. The basal cisterns are effaced.

The right sigmoid sinus appears hyperdense.

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