 Brain: Scattered hyperattenuating foci within the left temporoparietal lobe, frontal lobe, basal ganglia, and midbrain tegmentum likely represent small intraparenchymal hematomas/contusions. Trace blood product is also seen within the interpeduncular cistern. Trace subdural blood product is suspected along the right pterion. Areas of parenchymal hemorrhage on the straight mild edema. However, no significant generalized mass effect or brain Abnormal T2 hyperintensity is present within the bilateral frontal lobes (left much greater than right), left bilateral temporal lobes (left much greater than right), anterior body of the corpus callosum, bilateral basal ganglia including prominence of the posterior limbs of the internal capsules, as well as within the midbrain. Associated susceptibility hypointensity of corresponding hemorrhage or microhemorrhage is present involving the left frontal lobe, temporal lobe, corpus callosal, basal ganglia, and midbrain abnormality consistent with grade 3 exam axonal injury. There is mild medialization of the left uncus. Otherwise basilar cisterns are maintained. Redemonstrated is trace subdural hemorrhage along the right pterion. Interpeduncular cisternal hemorrhage is less apparent.Calvarial fractures and sutural diastases are better demonstrated on previous CT.The cerebellar tonsils are in normal position. The pituitary gland is normal in size. Flow voids are present within the major vessels indicating patency. Cervical spine:Straightening of the cervical spine is likely positional. There are no fractures or subluxations. The marrow signal is benign. There is mild increased T2 signal within portions of the skin as well as the immediately underlying superficial musculature at the approximate C3 and C4 levels suggesting mild subcutaneous injury. There are no MRI findings of ligamentous injury. The cervical cord is normal in signal. There are no osseous dysplasias or stenoses.Thoracic spine:There is a normal thoracic kyphotic curve. The vertebral body heights and disc spaces are maintained. Marrow signal intensity is benign throughout. The spinal cord has a smooth contour and is without focal atrophy, edema, or myelomalacia. There is increased T2 signal within portions of the skin as well as underlying superficial musculature at the approximate T4-T7 levels. Additionally, there is more significant skin and subcutaneous T2 hyperintensity centered in the midline spanning the levels from approximately T9 though L3. There are no osseous dysplasias or stenoses.Lumbar spine:Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. There is mild increased T2 hyperintensity within the paraspinal musculature from approximately L2 through S2 without interspinous ligamentous injury. Note is made of partial lumbarization of S1 with a rudimentary disc at S1/2. There are no osseous dysplasias or stenoses.
1.Brain MRI findings consistent with grade 3 axonal injury as described in detail above.2.There is mild medialization of the left uncus, otherwise basilar cisterns are maintained. 3.Redemonstrated is trace subdural hemorrhage along the right pterion4.No MRI evidence of spinal cord injury.5.MRI findings consistent with skin, subcutaneous, and paraspinal muscular injury of the spine as described in detail above without definitive ligamentous injury.