Traumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, initial encounter [S06.359A], Reason for Study: ^Reason: eval vasculature History: likely traumatic left splenium ICH Brain MRIThere is linear T1 high signal intensity lesion at the left corpus callosum splenium which is corresponding to the CT high attenuation lesion. The lesion does not show evidence of enhancement and does not show significant susceptibility artifacts either. Surrounding edema cannot be evaluated due to limited image sequences. There is no other hemorrhagic lesion on this scan. Constellation of above findings indicate early subacute parenchymal hemorrhage.There is no evidence of acute ischemic infarction.There is no evidence of abnormal enhancement.The left cerebellar hemispheric DVA is again seen, unchanged since prior scan. The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.No evidence of intracranial arterial aneurysm. No arterial stenosis.Brain MRV3D Phase contrast MRV brain with maximum intensity projections of the superficial/deep intracranial venous drainage demonstrate normal flow enhancement in the superior sagittal sinus, transverse sinuses, sigmoid sinuses, internal cerebral veins, vein of Galen and straight sinus.
1. Linear left corpus callosum splenium lesion most likely represent early subacute parenchymal hemorrhage. No other hemorrhagic lesion is seen.2. No evidence of acute ischemic lesion.3. Normal brain MRA and MRV.Comment: unusual location, unusual shape parenchymal hemorrhage may need further imaging investigation such as catheter angiography. 