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Fig. 2 | Critical Care

Fig. 2

From: Impact of a posttraumatic cerebral infarction on outcome in patients with TBI: the Italian multicenter cohort INCEPT study

Fig. 2

CT scan showing posttraumatic cerebral infarction (PTCI). A1 MCA PTCI: acute parietal subdural hematoma on the right side (long arrow), extending to the falx (short arrow). A2 CT scan 9 days later showed an acute ischemic lesion in the superficial territory of the right MCA (preserved right lenticular nucleus, white *). B2 PCA PTCI: acute subdural hematoma along the right side of the tentorium (empty arrow), extra-axial blood in the prepontine cistern (short arrow), and small para sellar bubble air (long arrow) on admission brain CT. B2 Brain CT scan at 15 days showed complete effacement of the basal cisterns and bilateral temporo-occipital hypodensities (*), consistent with acute ischemic lesions in the territory of both PCA. C1 ACA PTCI: hemorrhagic contusions of the right frontal lobe mixed with air and perilesional vasogenic edema, intraventricular hemorrhage, a thick left frontoparietal acute subdural hematoma (long arrow) with midline shift to the right, and a thin acute subdural hematoma along the posterior falx (double arrows). C2 Left frontoparietal craniectomy and hematoma evacuation showed multifocal hypodensities in the anterior and posterior portion of the left cingulate gyrus (white outlined arrows), consistent with acute ischemic lesions in the territory of the left ACA. The small hypodensity in the genu of the corpus callosum (short arrow), barely visible in the first exam, is consistent with a shear-strain injury. D1 Superficial watershed PTCI: thick acute subdural hematomas along the whole tentorium and the left frontotemporal convexity. Diffuse subarachnoid hemorrhage is also visible at the vertex (long white arrows). D2 Bilateral cortical hypodensities in the posterior parasagittal regions (black arrows), consistent with acute watershed ischemia at the boundary zone between the MCA and ACA territories. Note the probe for the intracranial pressure monitoring in the left frontal lobe (short white arrow)

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