Bilateral Posterior Temporal Lobe Contusions as a Rare Pattern of Traumatic Brain Injury

A 56-year-old woman was found hypothermic on her bathroom floor with a scalp wound, laboratory results indicating long lie. She lethargic and had difficulties finding words. CT scan revealed symmetric posterior temporal lobe hypodensities punctiform hemorrhagic transformation (figure). Radiologic differential diagnosis included encephalitis,1 but CSF showed normal cytosis, xanthochromia, elevated protein. Contusions are the most common intra-axial injuries, caused by sudden deceleration impact of brain against bone or dura mater.2 In this case, occurred symmetrically tentorium cerebelli, presumably fall straight vertex while patient exiting bathtub.