Case 287

Medical History

A 76-year-old male patient admitted to the Emergency Room with headache and mental confusion, after 24 hours of falling from approximately 6 meters of height. Computed tomography (CT) of the head was performed for diagnostic elucidation.

Non-contrasted axial computed tomography (CT) scan of the head in third ventricle level.

Non-contrasted axial computed tomography (CT) scan of the head in the pontine level.

Given the clinical case and the images provided, what is the most likely diagnosis?

Test Question

(HUAC - Federal University of Campina Grande / 2015) A 24-year-old patient entered the ER with a history of cranial trauma 4 hours ago during a football match (he collided with another player). At the time of the trauma, the patient did not lose consciousness and continued to play. After 20 minutes of the trauma, he progressed with headache and asked to be replaced. After 45 minutes, he presented worsening of the headache and started vomiting. After 2 hours of trauma, he evolves with drowsiness and progressive lowering of the level of consciousness.

On admission in trauma’s hospital Glasgow coma scale was 7 with anisocoria on the right. What is the probable diagnosis?

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