Radiology Rounds Computed Tomography

 

TRANSTENTORIAL HERNIATION WITH RIGHT TEMPORAL HORN DILATATION

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Note the arrowhead pointing to the markedly dilated right temporal horn of the lateral ventricle and lack of similar findings on the contra-lateral side.

The ambient cistern is obliterated compatible with transtentorial herniation. The dilatation of the right temporal horn is due to compression of the atrium of the right lateral ventricle which impedes the normal flow of CSF.

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SUBFALCINE HERNIATION

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Left temporal intraparenchymal hemorrhage (small laterally placed arrow) with associated subfalcine herniation (medially situated arrow head). There is associated contra-lateral frontal horn dilatation (double arrow head) due to the obstruction at the foramen of monroe due to the subfalcine herniation./font>

INTRAVENTRICULAR BLOOD

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Left acute temporal intraparenchymal hemorrhage (the double arrow) with associated subfalcine herniation (medially situated single arrow) with intraventricular spill (lower situated single arrow) with contra-lateral dilatation of the frontal as well as the temporal horns of the lateral ventricle due to a combination of subfalcine as well as transtentorial herniation and subfalcine herniation.