5-month-old male with subdural hematoma, seizure. MRI BRAIN: Again seen are bilateral subdural collections along the bilateral cerebral convexities which are of CSF intensity within the frontal region and demonstrate high signal posteriorly. Intermediate density which is higher than of CSF is well demonstrated on recent CT in the bilateral frontal region. The collections measure up to 9 mm in greatest dimension along the frontal convexities. There is some displacement of the cortical vessels away from the inner table of the calvarium which indicates that these collections are subdural in location; however there may be a component of enlargement of the subarachnoid spaces as well. No foci of intraparenchymal hemorrhage or edema are noted. There is mildly increased vascularity/enhancement in the right parietal region which may be related to seizure as indicated in history versus congestion. There is mild enhancement of the posterior dura including along the tentorium, which is likely reactive. There is no restricted diffusion to suggest acute ischemia. No intracranial mass lesions noted. Gray-white matter differentiation is well preserved. No midline shift or herniation.The paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.MRI CERVICAL SPINE: Cervical spine is in anatomic alignment. Vertebral body heights are normal. Spinal cord is normal in signal intensity with no evidence of cord edema or hemorrhage. No epidural hematoma. No spinal canal or neural foraminal stenosis. The ligamentous structures are intact. The transverse ligament is intact. There is minimal fluid along the atlantooccipital joint bilaterally, which is nonspecific.
1. Again seen are subdural hematomas involving the bilateral cerebral convexities. Thin subdural hematoma component posteriorly with T1 hyperintensity and hyperdensity on recent CT is compatible with recent subdural hemorrhage. Larger component which is similar to CSF in intensity along the anterior frontal convexities may represent coexisting subdural hygroma (CSF) versus chronic blood products. No evidence of intraparenchymal hemorrhage or intraparenchymal edema.2. Subtly increased vascularity and possible leptomeningeal enhancement in the right parietal region may be postictal in etiology.3. No evidence of injury to the cervical spine.