71-year-old female with numbness. Evaluate expansion of subdural fluid collection. Redemonstrated are the findings from a previous left-sided craniotomy for aneurysm clip placement along the anterior communicating artery region. A previously demonstrated hypodense focus in region of the anterior limb of the left internal capsule, into aspect of the left lentiform nuclei and the left globus pallidus is again seen. There is associated ex vacuo dilatation of the anterior horn of the left lateral ventricle. Note is made of a small hypodensity within the anterior limb of the right internal capsule, unchanged. Note is made of a mixed density fluid collection along the right frontoparietal region, most consistent with an extra-axial hematoma. Note is made of mass effect with associated sulcal effacement of the right hemisphere in the surrounding area. No evidence of intraparenchymal hemorrhage. The remainder of the CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Redemonstrated is a hyperdense, bone density lesion along the inner table underlying left-sided periorbital gyri, without significant parenchymal mass effect.
1. Mixed density fluid collection overlying the left frontoparietal lobes consistent with a extra-axial hematoma, corresponding to the findings seen on recent MRI performed on 4/15/2013. No evidence of intraparenchymal hemorrhage.2. Status post aneurysm clipping of anterior communicating artery region aneurysm. 3. Expected evolution of prior infarct in region of the anterior limb of the left internal capsule with development of encephalomalacia and associated ex vacuo dilatation of the anterior horn of the left lateral ventricle.4. Small hypodensity within the anterior limb of the right internal capsule may represent prior remote lacunar infarct.5. Stable calvarial osteoma.