Clinical question:? Intracranial hemorrhage. Signs and symptoms: Status post blunt head trauma and loss of consciousness. CT of brain without infusion:Diffuse periventricular and subcortical foci of decreased attenuation in bilateral cerebral hemispheres are not specific however more likely diagnosis of small vessel disease and multiple sclerosis should be considered. Please correlate with history. There are no old studies available. There is no associated mass effect with the above findings. The cortical sulci and ventricular system remain within normal. There are no old studies for comparison and please correlate with clinical findings and history and if clinically desired follow-up with an MRI is recommended. No evidence of any post traumatic finding is detected.Calvarium is intact. Mastoid air cells, middle ear cavities and limited view of paranasal sinuses are unremarkable. No abnormality of the scalp is detected.CT of the maxillofacial region:Paranasal sinuses are well pneumatized and with no evidence of acute or chronic sinus disease. The ostiomeatal units of maxillary sinuses are patent bilaterally. Images through the nasal cavity demonstrate minimal nasal septum deviation to the left and a very small approximately 3 mm bony septal spur projecting to the left.Images through the orbits demonstrate no evidence of adenopathy.The minimal soft tissue thickening of the right cheek is present.
1.No evidence of post traumatic finding on CT of brain.2.Findings highly suspect that of advanced small vessel disease or demyelinating disease as described. Follow-up with an MRI is recommended.3.With the exception of minimal soft tissue thickening/edema of the right cheek the CT of maxillofacial region remains within normal. 