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"Swirl Sign" in Extradural Hematoma
Vipin Kumar Gupta1, Abhinav Seth1
1Government Medical College and Hospital, Chandigarh, India.
World Neurosurgery
|October 14, 2018
Summary
The "swirl sign" on CT scans indicates active bleeding in extradural hematomas after head trauma. Early surgical intervention for this sign can improve patient prognosis and survival.
Area of Science:
- Neuroradiology
- Neurosurgery
- Emergency Medicine
Background:
- Extradural hematomas (EDHs) are a common consequence of head trauma.
- Noncontrast computed tomography (CT) is a primary imaging modality for evaluating head injuries.
- Identifying active intracranial bleeding is crucial for timely surgical management.
Observation:
- The "swirl sign" is an uncommon finding on noncontrast CT scans in patients with EDH.
- This sign has two components: a hyperacute area indicating active bleeding and an acute area of clotted blood.
- The presence of the swirl sign suggests ongoing intracranial hemorrhage.
Findings:
- The swirl sign on CT is associated with active, ongoing bleeding within an extradural hematoma.
- It signifies a potentially expanding lesion requiring urgent attention.
- Two clinical scenarios highlight the significance of this sign.
Implications:
- Early identification of the swirl sign by surgeons is critical.
- Prompt and aggressive surgical management is warranted when the swirl sign is present.
- Timely intervention may positively impact patient prognosis and survival rates in cases of extradural hematoma.