25 year-old woman with bilateral basal ganglia hypodensity. Evaluate question of increased swelling. Portable head CT. Examination of the brain stem and posterior fossa structures is limited due to artifact.The basal ganglia, surrounding subcortical white matter, and internal capsule exhibit marked hypoattenuation bilaterally consistent with edema. Accounting for differences in technique, these findings appear to be stable from the MRI dated 8/14/2008. On the current study, there are two focal areas of hyperattenuation in the region of the right internal capsule which are consistent with punctate hemorrhage. On the prior MRI, there are no corresponding findings in this region, suggesting interval change.There is effacement of the cortical sulci suggestive of cerebral edema. Gray-white differentiation is preserved. The right basal ganglia exert mass effect upon the right lateral ventricle causing partial effacement. There are no findings of obstructive hydrocephalus.The calvaria and skull base are radiographically normal. Mucosal thickening is present in the sphenoid sinus and ethmoid air cells. There is partial opacification of the mastoid air cells bilaterally.An endotracheal tube is present. A nasogastric tube enters through the left naris.
1. Bilateral hypoattenuation of the basal ganglia and surrounding white matter consistent with edema. Accounting for differences in technique, this finding appears roughly stable from the prior MRI.2. Focal areas of hyperattenuation in region of right internal capsule consistent with punctate hemorrhage.3. Effacement of cortical sulci consistent with cerebral edema.4. Limited evaluation of brainstem and posterior fossa.