Closed head injury, new tremor, gait disorder. There is an area of T2/flair hyperintensity in the right frontal lobe involving the right superior and middle frontal gyri extending to the cortical surface. There is associated susceptibility compatible with chronic blood products. Finding may be related to prior ventriculostomy catheter with chronic blood products along the surgical tract. Mild associated ex vacuo dilatation of the right frontal horn. There is also evidence of chronic hemorrhage involving the left superior parietal lobule. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. There is mild global parenchymal volume loss, commensurate with age. There is prominence of the ventricular system which appear slightly out of proportion to the degree of volume loss. Additional scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses are clear. Minimal opacification of the mastoid air cells. Bone marrow signal is within normal limits.
1. No acute findings. No intracranial mass or mass effect.2. T2/flair hyperintensity in the right frontal lobe extending from the cortical surface to the ventricle, presumably related to prior ventriculostomy catheter and associated gliosis. Correlate with prior surgical history. There is associated susceptibility effect compatible with chronic blood products and mild associated volume loss. Focus of chronic hemorrhage is also noted in the left superior parietal lobule.3. Prominence of the ventricular system which appears slightly out of proportion to the degree of mild global parenchymal volume loss. Component of communicating hydrocephalus cannot be excluded; correlate with clinical findings.4. Mild chronic small vessel ischemic changes.