Altered mental status, unspecified [R41.82], Reason for Study: ^Reason: mid brain damage History: bilateral blown pupils There is right thalamic acute ICH extended toward midbrain and possibly upper pons associated with IVH and mass effects.Midline shift toward left side at the level of foramen of Monroe is measured about 12mm, no significant interval change since prior scan.Ventriculostomy tube was inserted through the left frontal burr hole with track hematoma.There is evidence of right frontal burr hole with linear white matter high signal intensity indicating prior ventriculostomy tube track.No evidence of acute ischemic lesion on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, or restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. Mucosal thickenings on paranasal sinuses and fluid collections on bilateral mastoid air cells.
1. Large right thalamic ICH which extends through the midbrain and possibly upper pons with IVH and surrounding edema. Midline shift toward left side is measured about 12mm.2. Ventriculostomy tube inserted through the left frontal burr hole with minimal track hematoma.