History: altered mental status, found down
Yeah, subarachnoid blood. Anything more interesting or worrisome?
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Hypodense swollen midbrain with linear hemorrhage on the left (oh yeah and some blood in the basilar cisterns). Don’t forget the transtentorial herniation!
Answer = Duret hemorrhage
Very bad! Herniation of the midbrain/pons/brainstem causes injury to perforating arteries or veins. Associated with extremely high mortality.