Traumatic brain injury, evaluate pituitary. Brain: There are numerous scattered foci of high T1 signal and susceptibility effect within the right inferior frontal, left basal ganglia, and left frontal, temporal, and insular lobes with associated vasogenic edema, as well as small areas of restricted diffusion in the left insular and basal ganglia. There is also edema in the left posterior corpus callosum, hypothalamus, left more than right, left thalamus, posterior limb of the right internal capsule, and midbrain. There are also scattered foci of susceptibility effect in the midbrain, pons, and right basal ganglia. There are small subdural hematomas along the bilateral cerebral convexities, measuring up to 3 mm in thickness. There is no midline shift or herniation. There is mild effacement of the left lateral ventricle. There is a mega cisterna magna. The major cerebral flow voids are intact. Mucosal thickening of the right maxillary sinus is noted. The orbits are grossly unremarkable. The multiple skull fractures are better depicted on the prior CT. There is a 10 mm thick left scalp hematoma and bilateral tympanomastoid fluid, with T1 hyperintense components suggestive of blood products.Pituitary: The pituitary gland is not enlarged and demonstrates an intact posterior bright spot and homogeneous enhancement. The infundibulum also appears to be intact.
1. Interval evolution of stigmata related to supratentorial and infratentorial diffuse axonal injury and hemorrhagic contusion with mild medialization of the left uncus. 2. Interval evolution of the small bilateral cerebral convexity subdural hemorrhages.3. Multiple skull fractures are better delineated on the prior CT.4. Edema related to traumatic brain injury is present within the hypothalamus, but the pituitary and infundibulum appear to be intact.