Click on Images for Enlarged View
Findings: Image #1 and #2 are noncontrast enhanced axial CT images which demonstrate increased density within the posterior aspect of the left cerebellum. There is associated mass effect on the left aspect of the 4th ventricle and quadrigeminal plate cistern.
Diagnosis: Cerebellar contusion.
Discussion: Cerebellar contusions are the most common lesion identified as a sequelae of head trauma. They are characterized by superficial regions of punctate hemorrhage occurring along gyri. They appear as heterogeneous regions of increased density most commonly identified along the frontal lobe convexity or temporal lobes. These are characteristic locations secondary to being located near bony protuberances. The inferior surface of a cerebellar hemisphere is a less common site of contusion. The lesions may be "coup" or "contra-coup". A coup lesion is directly adjacent to the site of impact, whereas a contra-coup lesion is a contusion which appears remote from the site of impact, and develops due to sudden deceleration forces. Contusion may enhance following contrast administration. MRI is overall more sensitive than CT in the detection of cortical contusions, particularly in the subacute stage.
References:
Submitted by: