The patient did have extensive cranial vault reconstructive surgery with osteotomies along the coronal sutures as well as bony fusion. Similar changes are present along the superior sagittal and frontal sutures. Growth along the transverse diameter of the head is less than on the anterior posterior diameter but there has been more craniocaudal growth and less frontal bossing. There are foci of severe bony thinning or defects. The overall appearance is within expected. Small ossification just external to the skull at midline posteriorly may represent heterotopic ossification. The patient has preserved gray-white differentiation and volume. There is no intracranial hemorrhage. The ventricles are normal in size. The orbits are normal. Mastoid air cells and imaged paranasal sinuses are clear.
anatomical entity_fin: {'coronal sutures': {}}procedure_fin: ['osteotomies']clinical findings_fin: {'extensive cranial vault reconstructive surgery': {'clinical finding': 'extensive cranial vault reconstructive surgery', 'existence': 'pos_dx', 'descriptive_term': 'extensive cranial vault reconstructive', 'observation': 'surgery', 'strength_term': 'extensive'}, 'coronal sutures': {'clinical finding': 'coronal sutures', 'existence': 'pos_dx', 'descriptive_term': 'coronal', 'observation': 'suture'}, 'bony fusion': {'clinical finding': 'bony fusion', 'existence': 'pos_dx', 'descriptive_term': 'bony', 'observation': 'fusion'}}location descriptor_fin: ['superior']object_fin: ['sutures']clinical findings_fin: {'similar changes': {'clinical finding': 'similar changes', 'existence': 'pos_dx', 'descriptive_term': 'similar', 'observation': 'change'}}anatomical entity_fin: {'head': {}}location descriptor_fin: ['anterior', 'posterior']clinical findings_fin: {'less frontal bossing': {'clinical finding': 'less frontal bossing', 'cf_snomed': {'frontal bossing': 90145001}, 'existence': 'pos_dx', 'descriptive_term': 'less frontal', 'observation': 'boss', 'quantity_term': 'less'}}imaging observation_fin: ['foci']clinical findings_fin: {'severe bony thinning': {'clinical finding': 'severe bony thinning', 'existence': 'unc_dx', 'descriptive_term': 'severe bony', 'observation': 'thinning', 'strength_term': 'severe'}, 'defects': {'clinical finding': 'defects', 'cf_snomed': {'defect': 6920004}, 'existence': 'unc_dx', 'observation': 'defect'}}clinical findings_fin: {'overall appearance is within expected': {'clinical finding': 'overall appearance is within expected'}}anatomical entity_fin: {'skull': {}}location descriptor_fin: ['external', 'midline']clinical findings_fin: {'small ossification': {'clinical finding': 'small ossification', 'existence': 'pos_dx', 'descriptive_term': 'small', 'observation': 'ossification', 'strength_term': 'small'}, 'heterotopic ossification': {'clinical finding': 'heterotopic ossification', 'cf_snomed': {'heterotopic ossification': 128491006}, 'existence': 'unc_dx', 'descriptive_term': 'heterotopic', 'observation': 'ossification'}}clinical findings_fin: {'gray-white differentiation': {'clinical finding': 'gray-white differentiation', 'existence': 'pos_dx', 'descriptive_term': 'gray-white', 'observation': 'differentiation'}, 'volume': {'clinical finding': 'volume', 'existence': 'pos_dx', 'observation': 'volume'}}clinical findings_fin: {'intracranial hemorrhage': {'clinical finding': 'intracranial hemorrhage', 'cf_snomed': {'intracranial hemorrhage': 1386000}, 'existence': 'neg_dx', 'descriptive_term': 'intracranial', 'observation': 'hemorrhage'}}clinical findings_fin: {'ventricles are normal in size': {'clinical finding': 'ventricles are normal in size'}}anatomical entity_fin: {'orbits': {}}clinical findings_fin: {'orbits are normal': {'clinical finding': 'orbits are normal'}}anatomical entity_fin: {'mastoid air cells': {}, 'paranasal sinuses': {}}clinical findings_fin: {'mastoid air cells': {'clinical finding': 'mastoid air cells', 'existence': 'pos_dx', 'descriptive_term': 'mastoid air', 'observation': 'cell'}, 'clear': {'clinical finding': 'clear', 'existence': 'pos_dx', 'observation': 'clear'}}
<s>[INST] Write the finding section for a radiology report based on the following information: anatomical entity_fin: {'coronal sutures': {}}procedure_fin: ['osteotomies']clinical findings_fin: {'extensive cranial vault reconstructive surgery': {'clinical finding': 'extensive cranial vault reconstructive surgery', 'existence': 'pos_dx', 'descriptive_term': 'extensive cranial vault reconstructive', 'observation': 'surgery', 'strength_term': 'extensive'}, 'coronal sutures': {'clinical finding': 'coronal sutures', 'existence': 'pos_dx', 'descriptive_term': 'coronal', 'observation': 'suture'}, 'bony fusion': {'clinical finding': 'bony fusion', 'existence': 'pos_dx', 'descriptive_term': 'bony', 'observation': 'fusion'}}location descriptor_fin: ['superior']object_fin: ['sutures']clinical findings_fin: {'similar changes': {'clinical finding': 'similar changes', 'existence': 'pos_dx', 'descriptive_term': 'similar', 'observation': 'change'}}anatomical entity_fin: {'head': {}}location descriptor_fin: ['anterior', 'posterior']clinical findings_fin: {'less frontal bossing': {'clinical finding': 'less frontal bossing', 'cf_snomed': {'frontal bossing': 90145001}, 'existence': 'pos_dx', 'descriptive_term': 'less frontal', 'observation': 'boss', 'quantity_term': 'less'}}imaging observation_fin: ['foci']clinical findings_fin: {'severe bony thinning': {'clinical finding': 'severe bony thinning', 'existence': 'unc_dx', 'descriptive_term': 'severe bony', 'observation': 'thinning', 'strength_term': 'severe'}, 'defects': {'clinical finding': 'defects', 'cf_snomed': {'defect': 6920004}, 'existence': 'unc_dx', 'observation': 'defect'}}clinical findings_fin: {'overall appearance is within expected': {'clinical finding': 'overall appearance is within expected'}}anatomical entity_fin: {'skull': {}}location descriptor_fin: ['external', 'midline']clinical findings_fin: {'small ossification': {'clinical finding': 'small ossification', 'existence': 'pos_dx', 'descriptive_term': 'small', 'observation': 'ossification', 'strength_term': 'small'}, 'heterotopic ossification': {'clinical finding': 'heterotopic ossification', 'cf_snomed': {'heterotopic ossification': 128491006}, 'existence': 'unc_dx', 'descriptive_term': 'heterotopic', 'observation': 'ossification'}}clinical findings_fin: {'gray-white differentiation': {'clinical finding': 'gray-white differentiation', 'existence': 'pos_dx', 'descriptive_term': 'gray-white', 'observation': 'differentiation'}, 'volume': {'clinical finding': 'volume', 'existence': 'pos_dx', 'observation': 'volume'}}clinical findings_fin: {'intracranial hemorrhage': {'clinical finding': 'intracranial hemorrhage', 'cf_snomed': {'intracranial hemorrhage': 1386000}, 'existence': 'neg_dx', 'descriptive_term': 'intracranial', 'observation': 'hemorrhage'}}clinical findings_fin: {'ventricles are normal in size': {'clinical finding': 'ventricles are normal in size'}}anatomical entity_fin: {'orbits': {}}clinical findings_fin: {'orbits are normal': {'clinical finding': 'orbits are normal'}}anatomical entity_fin: {'mastoid air cells': {}, 'paranasal sinuses': {}}clinical findings_fin: {'mastoid air cells': {'clinical finding': 'mastoid air cells', 'existence': 'pos_dx', 'descriptive_term': 'mastoid air', 'observation': 'cell'}, 'clear': {'clinical finding': 'clear', 'existence': 'pos_dx', 'observation': 'clear'}} [/INST] The patient did have extensive cranial vault reconstructive surgery with osteotomies along the coronal sutures as well as bony fusion. Similar changes are present along the superior sagittal and frontal sutures. Growth along the transverse diameter of the head is less than on the anterior posterior diameter but there has been more craniocaudal growth and less frontal bossing. There are foci of severe bony thinning or defects. The overall appearance is within expected. Small ossification just external to the skull at midline posteriorly may represent heterotopic ossification. The patient has preserved gray-white differentiation and volume. There is no intracranial hemorrhage. The ventricles are normal in size. The orbits are normal. Mastoid air cells and imaged paranasal sinuses are clear. </s>