A bashed head

aka Trauma Tribulation 003

A 27 year-old male was involved in head on collision at high speed.  He was GCS 8 at the scene.

A CT Head was performed:





List 5 abnormalities on the CT brain.

1.  depressed, comminuted fracture of the left temporal bone

2.  fracture involving the left orbit

3.  scalp haematoma overlying the fractured temporal bone (and you can even see a big laceration)

4. pneumocephalus

5. a small left sided acute subdural haemorrhage

6. a small left frontal intraparenchymal haemorrhage

Anything else?

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  1. Ivy says

    probably le fort III fracture, subcut emphysema right orbit, some subarachnoid blood, cerebral oedema, mild midline shift

  2. doncuan says

    1. acute subdural (NOT extradural despite the site)
    2. pneumocranium
    3. depressed fracture temporal and would have to look up other -- 4. sphenoid?
    tight base and I think maybe some 5. uncal herniation?
    no midline shift
    not much room in those ventricles but hard to say if effaced on limited slices