Presentation
Head injury in motor vehicle collision (MVC). Reduced level of consciousness.
Patient Data
WIthin the right frontal and temporal lobes are multiple foci of increased density with surrounding halos of low density. The areas of increased density represent hemorrhage within the brain parenchyma and the areas of low density represent edema.
There is also an acute subdural collection and associated mass effect with midline shift.
The right parenchymal hemorrhage and subdural hemorrhage has resulted in increased mass effect within the right hemisphere that has resulted in shift of the midline towards the left.
In addition, there has been effacement of the right lateral ventricle.
Case Discussion
Traumatic head injuries are very common and can be very serious.
In 2007 the US Centers for Disease Control and Prevention (CDC) estimated 1.1 million emergency presentations and 500,000 deaths attributed to head injuries.
With the forces involved, there are is a high likelihood of other injuries requiring investigation and management. In this case, the brain parenchyma has impacted against the skull base resulting in these bleeds and surrounding damage.
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Thanks to Dr Frank Gaillard for contributing this case (original available here).
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