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The swirl sign is a finding on noncontrast computed tomography in which an area of low attenuation lies within an otherwise high-attenuation (hyperattenuating) hematoma. The low-attenuation region is fresh, uncoagulated blood, which is less dense than the surrounding clotted blood, and its presence indicates that the hematoma is still actively bleeding. The sign is most often described in acute epidural (extradural) hematoma after head trauma.