Atypical Cerebral Concussion vs. Shunt Dysfunction
Left picture: The diagnosis is an atypical cerebral concussion because there is a continuous changing of the state of consciousness during several hours after the fall which is shown in the picture at the bottom with one of several spontaneous long periods of falling asleep. Right picture: The diagnosis is an advanced stage of shunt dysfunction.
Left picture: This patient can be roused already by addressing him loudly during the hours following the fall on the playground. Right picture: In spite of raising the eyelids the patient can not be awakened. In addition, a characteristic eye sign is visible on both sides, namely a setting sun sign. Left picture: As an extra finding, the boy has an anxious facial expression.