Case 28 Answer

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.

reference: https://radiopaedia.org/articles/duret-haemorrhage