Clinical question: 25 years old male with fevers, vomiting, headaches, mental status change. Rule out intracranial increase pressure, mass, bleed. Signs and symptoms: Altered mental status, vomiting, fever and headaches. Non-enhanced head CT:There is no evidence of intracranial hemorrhage, edema, mass, mass effect, midline shift or hydrocephalus.There is evidence of a prior in the right posterior temporal -- occipital junction with the extensor and inferior to the suboccipital region. There is underlying parenchymal encephalomalacia of right cerebellum and right occipital lobe. Please correlate with history regarding the reason for surgery. Follow-up with an MRI is recommended if there was a recurrence of tumor at this site. No acute finding on the current exam.Images through posterior fossa also demonstrate bilateral patchy and linear calcification that may be result of prior treatment. There is also ex vacuo dilatation of the fourth ventricle. Patchy calcification within the pons is also noted. This finding may be also result of prior treatment or a cavernoma. This finding and may also further evaluated with an MRI examination.Other than above described craniotomy calvarium is intact.Visualized mastoid air cells and middle ear cavities are unremarkable.There is limited view of paranasal sinuses are unremarkable.
1.No evidence of acute intracranial findings.2.Focal encephalomalacia right occipital and right cerebellum under a right-sided posterior temporal, occipital, suboccipital craniotomy site. Please correlate with past medical history.3.Patchy calcification of bilateral cerebellum may be result of prior treatment.4.Patchy calcification of the pons could result of prior treatment and or a cavernoma.5.If clinical concern persist recommend follow-up with an MRI exam.