history

History

• 30 years old male with trauma

findings

• A well-defined extraxial elliptical shape fresh blood density seen in the right fronto-parietal region.
• The lesion measured ……. cm in its maximal dimensions.
• The lesion exert little mass effect in the form of effacement of the cortical sulci and and mild midline shift.
• right fronto parietal subglial hematoma seen
• associated right fronto parital fracture seen
• no brain herniation.
• Normal size and configuration of the ventricular system.
• No intracerebral or intraventricular recent blood density.
• Normal appearance of the brain stem and cerebellum.

diagnosis

acute extradural hematoma with fracture

explanation

CT Findings:

• Biconvex (lentiform) hyperdense collection adjacent to the inner table of the skull.
• Does not cross sutures (limited by dural attachments).
• May cross the midline if located over the falx cerebri.
• Underlying skull fracture commonly visible, especially in the temporal region.
• Mass effect: midline shift, compression of adjacent sulci or ventricles.
• Lucent areas may represent active bleeding or mixed density if subacute/chronic.

MRI Findings (if done):

• Helps in dating the hemorrhage and assessing associated parenchymal injury.
• Signal intensity varies with blood age.
• Lentiform extra-axial collection with dural attachment but no extension across sutures.

Key Differential Diagnoses:

• Subdural hematoma: Crescentic shape, crosses sutures, follows the contour of the brain.
• Hemorrhagic contusion: Intra-axial and irregular.
• Epidural abscess: Similar location but rim-enhancing on post-contrast scan.

Complications:

• Brain herniation (especially uncal).
• Midline shift and raised intracranial pressure.
• Delayed neurological deterioration (lucid interval).

Reporting Tips:
Include:

• Location and side.
• Maximum thickness and volume if possible.
• Degree of mass effect or midline shift.
• Associated fractures or pneumocephalus.
• Any additional intracranial injuries.