Reason: intraparenchymal hemorrhage History: CT findings. Corrected gestational age at birth 34 1/7 weeks, preterm delivery. Vaginal forceps delivery with subsequent drop in hemoglobin and hematocrit. Apgar of 8 and 8. There is a small focus of intraparenchymal hemorrhage involving the left paramedian frontal lobe with associated restricted diffusion and T1 hyperintensity. There is an additional tiny punctate focus in the right frontal lobe with restricted diffusion, subtle T1 hyperintensity and subtle hyperdensity on recent CT and suspected to represent an additional petechial focus of hemorrhage. There is minimal edema associated with the left frontal lobe hemorrhage without mass effect, midline shift, or herniation. There are punctate foci of restricted diffusion within the left periventricular white matter compatible with acute white matter injury.There are bilateral subdural hematomas along the bilateral posterior parieto-occipital and posterior temporal convexities as well as along the cerebellar hemispheres without significant mass effect. Brain parenchyma appears otherwise appropriate for patient's early gestational age. No hydrocephalus. Remainder of the extra cranial soft tissues appear unremarkable.
1. Small left frontal lobe intraparenchymal hematoma similar to CT allowing for differences in technique. There also appears to be an additional punctate focus in the right frontal lobe. No significant associated mass-effect.2. Small bilateral subdural hematomas without significant mass effect, which may be related to birth related injury.3. Two foci of restricted diffusion in the left parietal white matter compatible with white matter injury of prematurity.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.