Post op SDH burr holes, with minimal responsiveness, increased tone. There are postoperative findings related to recent bilateral frontal burr holes and bilateral parietal burr hole drainage of bilateral cerebral convexity predominantly high T1 and T2 signal subdural hematomas, which are mixed with pneumocephalus and areas of relatively intermediate T1 and low T2 signal hemorrhage, but are not significantly changed in size, accounting for differences in technique. There are drainage tubes that course through the right frontoparietal burr hole and the left parietal burr hole, terminating in the bilateral subdural spaces. The right frontal convexity catheter forms a partial loop, indenting the underlying brain parenchyma. There are multiple curvilinear areas of susceptibility effect, which represent hemorrhage, and surrounding T2 hyperintensity, which represents vasogenic edema, in the bilateral frontal and parietal lobes related to catheter tract injuries. The transparietal tracts extend to the corpus callosum. Thine areas of apparent restricted diffusion accompanying portions of the bilateral parietal lobe tracts may be attributable to devitalized tissues along the margins of the tracts versus artifact from susceptibility effects. However, there is no acute territorial infarct. There is trace left lateral ventricular hemorrhage. There is scattered sulcal and basal cistern T2 hyperintensity, which corresponds to subarachnoid hemorrhage. There is persistent effacement of the basal cisterns and third and lateral ventricles. There is also persistent midline shift towards the right measuring approximately 6 mm and mild left uncal herniation.
1. Postoperative findings related to recent drainage of bilateral predominantly subacute cerebral convexity subdural hematomas with acute components, which have otherwise not significantly changed in size. The right frontal convexity catheter continues to form a partial loop and indents the underlying brain.2. Multiple areas of intraparenchymal hemorrhage and edema assocated with bilateral frontal and parietal cerebral contusions and lacerations, most of which are more conspicuous than on the previous CT examinations due to differences in technique.3. Persistent scattered subarachnoid hemorrhage and trace intraventricular hemorrhage.4. Persistent midline shift towards the right measuring approximately 6 mm and mild left uncal herniation.