Moderator EMEDPA Posted November 7, 2020 Moderator Share Posted November 7, 2020 Thoughts? Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted November 8, 2020 Share Posted November 8, 2020 No knowing anything other than "peds", given intact bony structures, I'm concerned about "non-accidental" trauma, in particular shaken baby. What was the history - reported or otherwise obtained? How old was the patient? Could anything be seen on fundoscopic exam? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 8, 2020 Author Moderator Share Posted November 8, 2020 13 yr old girl. Bike accident. 2 min LOC with witnessed seizure. Nl funduscopic. Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted November 8, 2020 Share Posted November 8, 2020 No one looking centrally at the image i guess... Quote Link to comment Share on other sites More sharing options...
MediMike Posted November 8, 2020 Share Posted November 8, 2020 7 minutes ago, GetMeOuttaThisMess said: No one looking centrally at the image i guess... Whatcha seeing? I'm not good with a single slice CTH. Need to scroll back and forth repeatedly. A) Because it makes me look real important B) Orient myself to the anatomy C) Buys me time while the nursing staff are huddled at my shoulder In all seriousness though I see no signs of a SDH, no SAH or obvious ICH. No mass or shift. You're hovering over the pons and your fourth ventricle looks collapsed and there's no signs of the suprasellar cistern...but again I have no idea where I'm at. Disclaimer: I'm medical not trauma 1 Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted November 8, 2020 Share Posted November 8, 2020 Not sure about the linear opacification at 7 o’clock. Quote Link to comment Share on other sites More sharing options...
MediMike Posted November 8, 2020 Share Posted November 8, 2020 Pretty sure that's the right tentorium cerebelli. Would be super odd to see a linear distribution of anything in intracranial pathology...I think. Feel like everything is concave, convex round or wedge lol Quote Link to comment Share on other sites More sharing options...
MediMike Posted November 10, 2020 Share Posted November 10, 2020 @EMEDPA C'mon! Where's the follow-up? Your rads can't be that slow of a reader... although it certainly feels like it sometimes... Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 10, 2020 Author Moderator Share Posted November 10, 2020 On 11/8/2020 at 9:31 AM, MediMike said: Pretty sure that's the right tentorium cerebelli. Would be super odd to see a linear distribution of anything in intracranial pathology...I think. Feel like everything is concave, convex round or wedge lol Several of us felt the white line on the right was blood. That was right where the kid hit his head. Lifeflight was put on standby and plans were made to transfer to peds trauma center. Rads agreed with you that the right tentorium was "atypically thickened and asymetrical when compared to the right". That was my attempted teaching point here. This is a rare normal variant, not blood. Kid still got transferred for trauma obs by ground ALS, given the hx of 2 min loc with generalized sz. 1 Quote Link to comment Share on other sites More sharing options...
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