Presentation
An adult male was brought to the hospital after high impact road traffic accident followed by drowsiness ,vomiting & slurred speech.
Patient Data
A CT scan of the brain was performed 2 hours after a head injury. The scan shows a subdural hemorrhage (mean density 45-60 HU) with a thickness of 9 mm along the right cerebral convexity causing compression and effacement of the right lateral ventricle. The midline structures are deviated to the left by approximately 7 mm due to this mass effect. However, there is no evidence of obstruction in CSF outflow at this point. A subtle hyperdensity is also visible in the right parietal region, suggesting a hemorrhagic contusion.
The bone window demonstrates a displaced fracture in the condyle and ramus of the mandible on the right side.
Practical points
A small contusion or subtle fracture can be easily overlooked, so it's always worth taking an extra minute for the bone window, especially in post-traumatic cases to look for a possible fracture elsewhere.
Case Discussion
This case illustrates a classic post-traumatic acute subdural hemorrhage with cerebral hemorrhagic contusion and mandibular fracture in an adult male.
Unable to process the form. Check for errors and try again.