PMC9805635_01
(a-c) Coronal and axial images from unenhanced computed tomography scan brain reveal a large left temporal hemorrhagic contusion (blue arrow) with associated surrounding edema, resulting in mass affect and midline shift to right (Arrow head). There is accompanying effacement of the left-sided perimesencephalic basal cisterns raising the possibility of impending uncal herniation (curved). Extensive left acute subdural hematoma and subarachnoid hemorrhage.
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F1
Coma Scale was 12/15 (E4V2M6). CT scan depicted a left temporal hematoma with extensive acute subdural hematoma, diffuse edema and mass effect, and midline shift of 6.6 mm [Figure 1].
Axial and coronal images from unenhanced computed tomography scan brain. (a and b) showing a craniectomy defect. (c and d) are the images taken 1 week after cranioplasty.
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F2
Suspecting "syndrome of trephined" and in view of his persistently unexplained behavioral dysfunction, we planned for early cranioplasty which was performed 6 weeks after the primary procedure [Figure 2].