Bilateral Posterior Temporal Lobe Contusions as a Rare Pattern of Traumatic Brain Injury

A 56-year-old woman was found hypothermic on her bathroom floor with a scalp wound, with laboratory results indicating long lie. She was lethargic and had difficulties finding words. CT scan revealed symmetric posterior temporal lobe hypodensities with punctiform hemorrhagic transformation (figure). Radiologic differential diagnosis included encephalitis,1 but CSF showed normal cytosis, xanthochromia, and elevated protein. Contusions are the most common intra-axial injuries, caused by sudden deceleration and impact of the brain against bone or dura mater.2 In this case, the impact occurred symmetrically against the tentorium cerebelli, presumably caused by a fall straight on the vertex while the patient was exiting the bathtub.

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