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Fig. 5.41 Posterior fossa fracture with small amount of pneumocephalus displayed on bone window.

Fig. 5.41 Posterior fossa fracture with small amount of pneumocephalus displayed on bone window.

traumatic petechial haemorrhages seen in the brain stem and right frontal cortex of a patient involved in a high speed motor vehicle accident. The extent of these shear injuries is often underestimated on CT and more widespread changes can frequently be demonstrated on MRI. These white matter shearing injuries occur in the setting of a diffuse impact injury with rotational forces. The cortex and deep structures move at different speeds 254 resulting in shearing stress especially at grey-white matter junctions.

Fig. 5.43 White matter shearing injury. CT head scan following high speed motor vehicle accident. There is a tiny acute haematoma in the brain stem. CT is relatively poor at demonstrating tiny haemorrhagic lesions which are better seen on MRI.
Fig. 5.44 Tiny haematoma in frontal lobe. MRI demonstrated multiple similar lesions.

Reference

1. Neuroanaesthesia Society of Great Britain and Ireland and the Association of Anaesthetists of Great Britain and Ireland. Recommendations for the Transfer of Patients with Acute Head Injuries to Neurosurgical Units, 1996.

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