PMC6421046_01
Cranial computed tomography (CT) scan performed at the end of the surgery: brain swelling.
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It showed the appearance of a cerebral swelling (Figure 1).
Cranial CT scan after decompressive hemicraniectomy, insertion of external ventricular derivation, and intracranial pressure catheter: cerebral swelling; hematoma on the right frontotemporal-parietal craniectomy.
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A control brain CT scan was performed (Figure 2).
Magnetic resonance imaging, on diffusion-weighted imaging (DWI) sequences, performed 4 days after the trauma showing punctuate hyperintense foci: Starfield pattern.
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T2-weighted, fluid-attenuated inversion recovery, and diffusion-weighted magnetic resonance imaging showed diffuse punctate hyperintense foci of restricted diffusion in both cerebral and cerebellar hemispheres, with susceptibility artifacts on susceptibility weighted MRI sequences in keeping with petechial hemorrhagic foci, in a starfield pattern (Figure 3).
Magnetic resonance imaging at 3 months on DWI sequences showing a regression of punctate hypersignal lesions.
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The cerebral MRI at three months showed a regression of the multiple punctate hypersignal lesions on diffusion sequences and a disappearance of the hypersignals FLAIR and diffusion of the striatum (Figure 4).