Extra-axial hemorrhages with skull fracture

Discussion:

This case demonstrates multiple abnormalities including skull fracture and acute subdural hemorrhage. There are areas of low density within the subdural hemorrhage suggesting active bleeding.

Adjacent to the subdural are linear areas of high density that extend towards the midline. This is blood within the sulci - subarachnoid hemorrhage.

On the opposite side of the brain, there are focal areas of hemorrhage within the brain parenchyma - the brain has been smashed against the skull during deceleration causing injury on the opposite side to the collision.

The skull fracture is also associated with a large extracranial hematoma (subgaleal collection).

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Thanks to Dr David Cuete for originally uploading this case. It can be viewed here, along with the bone windows of the CT.

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