Case Notes
History
69 yo female with one week history of severe headaches with emessis. No history of trauma nor clotting disorder/medication.Exam
MR T2-w coronal
Prior Study
MR T1-w noncontrast axial MR1. There is a focal intraaxial right parietal hematoma plus both lateral and parafalcine right subdural hematomas producing 16 mms of right ot left subfalcine shift.
2. The subfalcine shift has pulled the mesencephalon to the left impacting the left tentorial free margin with compression of the left cerebral peduncle and apparent deep mesencephalic edema, which might be on an ischemic basis associated with perforator shear effects.
3. The subfalcine shift has caused left lateral ventricular obstruction with early hydrocephalus.