Assess for DAI s/p MVASpinal epidural and cervical spine fractures identified on CT. assess for associated injuries.Injury, other and unspecified, unspecified site MRI brain:Since the prior CT exam an intracranial pressure monitor has been removed.There is a subdural hematoma adjacent to the right tentorial leaf which is 1 or 2 mm in thickness. This extends adjacent to the right temporal, occipital and parietal lobes. This is stable compared to the previous exam.Multiple punctate foci of SWI signal loss are present in the frontal, parietal and temporal lobe subcortical white matterA small amount of subarachnoid space FLAIR signal hyperintensity is present along the high convexities of the parietal lobes and posterior aspect of the frontal lobes. This is most likely related to oxygen.There is redemonstration and no change in left-sided scalp soft tissue swelling The CSF spaces are appropriate for the patient's stated age with no midline shift. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a left maxillary sinus opacity and scattered opacities and mucosal thickening in the ethmoid air cells. The visualized portions of the mastoid air cells demonstrate some fluid in the mastoid air cells. The patient is status post intubation. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment. The cervical spinal cord has normal signal characteristics and overall morphology. There is a compression fracture present at the C7 vertebral body involving the anterior and middle columns. There is approximately 20% loss of vertebral body height. There is very minimal posterior displacement of the left posterior aspect of the vertebral body.Findings suggest a 2 mm thick ventral epidural soft tissue mass eccentric towards the right side extending from the C5-6 disc space level to the T1-T2 disc space level. This is associated with minimal displacement of the thecal sac. The spinal fluid surrounding the spinal cord is not effaced. The size is unchanged since the prior exam.There is a nondisplaced fracture present along the right C3 inferior facet which extends into the right C3-4 facet joint.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. The right vertebral artery is small relative to the left vertebral artery.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There is a right pleural effusion present.
1.There is a thin subdural hematoma present adjacent to the right tentorial leaf and right temporal, occipital and parietal lobes. This is stable compared to the prior CT exam.2.There are multiple microhemorrhages throughout the frontal, medial temporal lobes and parietal lobes which are compatible with hemorrhagic diffuse axonal injuries.3.There is scalp soft tissue swelling present.4.There is a compression fracture present at C7 with some mild retropulsion. This is stable compared to the prior exam but better visualized on CT.5.Findings are suspicious for a thin ventral epidural hematoma extending from C5 down to T1-T2. This is eccentric towards the right side and with. To involve more right-sided nerve roots and hemicord compared to the left. This is stable compared to the prior CT exam. There is no associated compression of the spinal cord appreciated. 6.There is a right-sided C3 facet fracture present with minimal displacement. This is stable compared to the prior exam but better visualized on CT.7.There is no evidence for thoracic spine fracture.8.Since the prior CT examination intracranial pressure monitor has been removed.9.There is a right pleural effusion present.