Traumatic subarachnoid hemorrhage complicated by cerebral vasospasm

Case contributed by Henry Knipe , 17 Jun 2022
Diagnosis almost certain
Changed by Ryan Thibodeau, 13 Oct 2023
Disclosures - updated 20 Jan 2023: Nothing to disclose

Updates to Study Attributes

Findings was changed:

SmallA small volume of left frontal subarachnoid haemorrhagehemorrhage. Tiny contusion in the left temporal lobe and a further left parietal contusion with adjacent subarachnoid haemorrhagehemorrhage.  No mass effect or herniation. Grey-white differentiation is maintained. Periventricular hypoattenuation. Asymmetric left deep white matter hypoattenuation foci may represent ischaemiaischemia/infarct. No hydrocephalus or extra-axial fluid collections. 

Updates to Study Attributes

Findings was changed:

Increased left MCA territory TMax with mainly deep white matter midlymildly reduced CBV but preserved CBF. 

Automated calculations:Infarct core: 2 mLTissue at risk: 83 mLMismatch ratio: 41.5

Images Changes:

Image 11 CT (TMax) ( create )

Annotation 5241 changed from ,0 arrows,0 labels to Increased TMax ,4 arrows,1 label.

Updates to Study Attributes

Findings was changed:

No occlusion or hemodynamically significant stenosis. Terminal left internal carotid artery aneurysm involving the origin of the left middle cerebral artery. LeftThe left middle cerebral artery ishas a markedly smaller calibrecaliber than the right, particularly within the M2 division. No further intracranial aneurysm is identified.

Non-united dens fracture (type 2), no marked displacement although there is basilar impression.

Images Changes:

Image 83 CT (C+ arterial phase) ( update )

Annotation 5159 changed from 1 arrow,1 label to 2 arrows,1 label.

Image 83 CT (C+ arterial phase) ( create )

Annotation 5242 changed from ,0 arrows,0 labels to M2 division,2 arrows,1 label.

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