Female, 10 years old, status post motor vehicle collision with subdural hemorrhage. Evaluate for diffuse axonal injury. A 7 mm diffusion restricting and T2 hyperintense focus is evident within the corpus callosum at the junction of the posterior body and splenium (see image 13 series 701, and image 186 series 401).No other convincing areas of parenchymal signal abnormality are detected. Minimal FLAIR hyperintensity is seen in two or three of the right temporal sulci, though this could be artifactual or related to vascular flow.A very thin layer of T1 hyperintense fluid is evident along the right occipital lobe and right tentorium compatible with the known subdural hemorrhage. No additional significant extra-axial collections are seen. The ventricular system is normal in size and morphology.Metallic artifact is present overlying the right frontal bone. Elsewhere, marrow signal characteristics are unremarkable. Opacification of the right maxillary sinus and right ethmoid air cells is evident. Also seen is significant bilateral mastoid air cell opacification.
1.A focus of diffusion restriction and T2 hyperintensity is evident at the junction of the posterior body and splenium of the corpus callosum. This could represent a site of axonal shear injury, and indeed, this is a fairly typical location for such an injury.2.No definite additional parenchymal lesions are detected. A thin layer of subdural blood is seen along the right occipital lobe and tentorium.3.Significant paranasal sinus and mastoid opacification is redemonstrated.