The yin-yang shaped image following head injury
Ali Akhaddar
The Pan African Medical Journal. 2013;16:133. doi:10.11604/pamj.2013.16.133.3555

Create an account  |  Sign in
PAMJ Conf Proceedings PAMJ Conf Proceedings
"Better health through knowledge sharing and information dissemination "

Images in medicine

The yin-yang shaped image following head injury

Cite this: The Pan African Medical Journal. 2013;16:133. doi:10.11604/pamj.2013.16.133.3555

Received: 05/11/2013 - Accepted: 30/11/2013 - Published: 09/12/2013

Key words: Head injury, craniofacial trauma, haematoma, yin-yang

© Ali Akhaddar et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/16/133/full

Corresponding author: Ali Akhaddar, Avicenne Military Hospital, 40000, Marrakech, Morocco (akhaddar@hotmail.fr)


The yin-yang shaped image following head injury

 

Ali Akhaddar1,2,&

 

1Department of Neurosurgery, Avicenne Military Hospital, 40000, Marrakech. Morocco/ University of Mohammed V-Souissi, 10100, Rabat, Morocco

 

 

&Corresponding author
Ali Akhaddar, Avicenne Military Hospital, 40000, Marrakech, Morocco

 

 

Image in medicine

A 33-year-old previously healthy man was admitted with a craniofacial trauma sustained in a road traffic accident. No post-traumatic seizures were documented. On physical examination, large wound was observed in the frontal region on the right side. He was comatose, and his consciousness level was 6 on the Glasgow Coma Scale. The right pupil was dilated but responsive to light. The axial slices of the cerebral computed tomography-scan (CT-scan) revealed a distorted right cerebral hemisphere with effacement of the basal cisterns, which was compressed by an extraaxial haematoma located in the right frontoparietal region. This haematoma was found to have two different components: the first (anterior) was epidural and the second (posterior) was subdural. Both haematomas were evacuated through a right frontoparietal craniotomy. Postoperatively, CT-scan showed no evidence of residual haematoma. The patient has been in good health throughout the 3-month follow-up since the accident. Classic CT-scan appearance of intracranial epidural haematoma (EDH) is high density biconvex shape adjacent to the skull and usually confined to small segment of calvaria. On the contrary, acute subdural haematoma (ASDH) appear more diffuse, less uniform, usually concave over brain surface and often less dense (from mixing with cerebrospinal fluid) than EDH. But when combined, these two different surgical entities are not easy to distinguish on CT-scan. The Yin-yang-shaped image seen in our patient is formed by an anterior biconvex shape and a posterior concave shape, the combination of adjacent epidural and acute subdural haematoma. The radiologic features of our presentation are interesting and might be useful to distinguish both adjacent EDH and ASDH.

Figure 1: A) Axial CT-scan showing extraaxial hemorrhagic lesion on the right frontoparietal region. This lesion has two different components: the first (anterior) was epidural and the second (posterior) was subdural. Note the limit within this lesion (arrows); B) The Yin-yang symbol or Taijitu

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


The Pan African Medical Journal articles are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 27 (May - August 2017)

Article tools

This article authors

On Pubmed
On Google Scholar

Navigate this article

Rate this article

Altmetric

Popular articles in Images in medicine

PAMJ is a member of the Committee on Publication Ethics

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved