66 years Male (DOB:7/16/1949)Reason: Evaluate for underlying mass or ischemia associated with cerebellar hemorrhage History: as abovePROVIDER/ATTENDING NAME: CHRISTOPHER L KRAMER CHRISTOPHER L KRAMER There is a 51 x 27 mm axial dimension hematoma involving the superior aspects of the vermis and left cerebellar hemisphere. There is associated mass effect with compression of the fourth ventricle.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Couple punctate foci of diffusion restriction are present in the right posterior cerebral artery territory in the left hippocampus.There are small foci of microhemorrhage identified in the basal ganglia and left insular cortex as well as right frontal lobe subcortical matter.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 small opacities in the maxillary sinuses and scattered opacities in the ethmoid air cells and left frontal sinus with some mucosal thickening in the sphenoid sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Incidental note is made of partial empty sella
1.There is redemonstration of a hematoma in the cerebellum which results in compression of the fourth ventricle.2.There are multiple microhemorrhages present in the basal ganglia and left insular cortex.3.A couple acute Microinfarcts are present in the right and left posterior cerebral artery territories. No ischemic infarction is identified in the brain tissue immediately surrounding the patient's hematoma.4.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 5.No contrast enhanced exam was performed. The examination is somewhat limited due to patient motion artifact and patient inability to complete the exam.