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Q. Is there any emergency observed in this head CT scan report?

Answered by
Dr. J. Mariano Anto Bruno Mascarenhas
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 04, 2016 and last reviewed on: Dec 18, 2021

Hi doctor,

The patient is a 47-years-old female. She met with an accident. In the accident, she had a collar bone fracture and a hit in the back of the brain. The back of the head is bulging, and some spots are observed in the brain CT scan. I have attached the head CT scan report for your reference.

It says the study reveals a small thin fluid density subdural hygroma seen along the left cerebral convexity measuring approximately 4.5 mm in maximum thickness. There is an associated mild mass effect seen, resulting in a mild above 2.5 mm midline shift towards the right side.

1. Attenuation values of the rest of the cerebral parenchyma are normal.

2. Bilateral basal ganglia and thalami appear normal.

3. Basal cisterns and Sylvian fissures are preserved.

4. No skull fracture seen.

Posterior fossa:

1. The fourth ventricle is normal in size and shape.

2. Cerebellar parenchyma is normal.

3. Region of the brain stem appears normal.

Please help.

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#

Hi,

Welcome to icliniq.com.

I have gone through your query with diligence and would like you to know that I am here to help you. I understand that the patient has been involved in an RTA (road traffic accident) and a collection of fluid within the brain. Would you please specify your exact question?

Kindly revert with an answer to help you further.

Hi doctor,

Thanks for your reply. The patient met with an accident eight days back. For the last two days, she has been having mild head pain. We would like to know the next course of action from our side. Is there any major medical emergency you observe that we need to address? Or can we go ahead with a general physician? For your information, I have attached the head CT scan report.

#

Hi,

Welcome back to icliniq.com.

The patient suffers from a left subdural hygroma of 4.5 mm maximum thickness with a midline shift of 2.5 mm (attachment removed to protect patient identity).

This means a fluid collection inside the skull between the skull and the brain on the left side, and this fluid collection pushes the brain to the right side. Hence the brain is compressed.

Because of this compression, the part of the brain, which is supposed to be in the middle, has been pushed to the right by 2.5 mm.

This has produced a headache. This is an emergency and needs urgent attention. The patient may even require surgery.

Please consult a neurosurgeon immediately.


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