Diagnosis: Headache(784.0)Subarachnoid hemorrhageClinical question: Please evaluate for lesions that may cause SAHSigns and Symptoms: headache, h/o SAH The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a linear increased T2 signal tract representing an old ventriculostomy tract located in the right frontal lobe.A previously noted punctate focus of diffusion restriction in the right parietal lobe white matter is reidentified and is associated with signal loss on SWI. The signal loss on SWI was not present on the prior exam. There are a couple other foci of punctate signal loss on SWI in the left temporal lobe and in the right occipital lobe adjacent to the right occipital horn.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There are several microhemorrhages identified within the brain parenchyma. These were not readily seen on the prior exam.2.There is no evidence for leptomeningeal disease.3.There is no MRI evidence for intracranial hypotension.4.There is no abnormal intracranial mass lesion identified.