PNR Head 12

History

16 year old F with Tylenol overdose

Major Findings

Diffuse sulcal effacement and mildly effaced basal cisterns suggestive of cerebral edema

Teaching Points

Make sure you can see all three shades of gray in the parenchyma, especially at the vertex:

(1) Lightest shade for gray matter

(2) Intermediate shade for white matter

(3) Darkest shade for CSF in the sulci (missing in this patient)

At the vertex this patient has only 2 shades of gray -- indicating the sulci are either compressed (cerebral edema, hydrocephalus) or filled with material other than CSF (blood, infectious debris, metastatic disease).

Accession: CL0675

Study description: CT HEAD W/O CONTRAST