Atypical Cerebral Concussion vs. Shunt Dysfunction

Left picture: The diagnosis is an atypical cerebral concussion which is frequently observed in children. Right picture: The diagnosis is a far-advanced shunt dysfunction which is recognizable by so-called herniation signs.

The toddler and the schoolchild are sleeping deeply. Left picture: In this toddler the state of sleeping (clouding of consciousness) is interrupted spontaneously by short episodes of waking; the patient can be woken up by a loud sound or pinching at all times. Right picture: This schoolchild does not wake up spontaneously and cannot be woken up from his unconsciousness. Left picture: This toddler had a fall on the playground. Right picture: Prior to the current state, headaches and a changing state of clouding of consciousness were present. Left picture: Signs of minor trauma are visible in the face. Right picture: There are no signs of trauma. The patient shows an intermittent posture of opisthotonus with reclination of the head, and extensor spasms of the extremities can be observed.