Case Study

CT – Traumatic comminuted fracture of the temporal bone with intracranial hemorrhage in a 8 year old MN DSH cat

This 8 year old MN DSH cat presented for lethargy, decreased appetite, ataxia, disorientation. Was bitten in the head by dog 1 week prior. PE: possibly blind

CBC/Chem: Glob incr 5.3, neutrophils incr, eos decr.

This 8 year old MN DSH cat presented for lethargy, decreased appetite, ataxia, disorientation. Was bitten in the head by dog 1 week prior. PE: possibly blind

CBC/Chem: Glob incr 5.3, neutrophils incr, eos decr.

Image Interpretation

CT of the head –

There is a comminuted fracture of the left temporal bone with dorsolateral displacement of mutiple sharply delineated small bony fragments. Next to the fracture an ovoid space occupying lesion of 1 cm diameter is seen within the left cerebral hemisphere level with the temporal lobe. Moderate rightward midline shift of the cerebral falx is noted owing to the mass effect of the lesion. An ill-defined hyperattenuating area with broad base to the calvarium is seen caudal to the lesion and compatible with epidural and/or intraparenchymal hemorrhage. The left temporal muscle is mildly swollen and heterogenous in attenuation. The left tympanic bulla contains a mild amount of gravity dependent uniformly hypoattenuating fluid

DX

• Traumatic comminuted fracture of the left temporal bone with intracranial hemorrhage and suspicion of a brain abscess versus necrosis • Suspicion of traumatic middle ear hemorrhage/otolymph extravastion. Theoretically this may be unrelated otitis media. However this is considered less likely.