4-month-old with full fontanelle and head CT showed subdural hemorrhage. Concern for nonaccidental trauma. Evaluate for ligamentous injury. BRAIN: There is no significant change in the degree of bilateral supratentorial and infratentorial subdural blood products with relative dependent location. The hemorrhagic clot along the left paramedian frontal lobe is slightly smaller. There are scattered foci of susceptibility artifact, consistent with blood degradation products. There is persistent prominence of the subarachnoid space anteriorly as well as mild prominence of the ventricles, likely relating to benign enlargement of subarachnoid spaces of infancy. The underlying subdural collections appear slightly increased in size, but this may be related to differences in modality. There is no evidence of mass or acute infarct. The pattern of myelination is appropriate for age. The basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. Patchy opacities are noted diffusely in the paranasal sinuses. A small amount of fluid is present in the mastoid air cells bilaterally.CERVICAL SPINE: The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. Partially imaged is atelectasis of the right upper lobe and left lower lobe.
1. Apparent slight interval increase in bilateral subdural collections, may be related to differences in modality. 2. No significant change in the degree of bilateral supratentorial and infratentorial subdural blood products.3. No evidence of ligamentous injury.4. Partially imaged atelectasis of the right upper lobe and left lower lobe.