Status post fall from 6 stories, status post removal of bolt. Evaluate for DAI. Evaluate for ligamentous injury, C1 fracture. Brain: Linear tract with T2/FLAIR hyperintensity is noted in the right frontal lobe related to prior ICP bolt. Remainder of the brain appears within normal limits. No evidence of intracranial hemorrhage. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. No extra-axial collections. Major flow-voids are preservedSella and orbits are grossly within normal limits. There is diffuse opacification of the paranasal sinuses and mastoid air cells which may be related to intubation. Bone marrow signal is within normal limits.Cervical Spine: Images of the cervical spine are slightly motion degraded. No convincing cord signal abnormality is appreciated. Fracture involving the anterior C1 arch on the left is better appreciated on recent CT. Atlantodental interval is maintained. Transverse ligament is intact. Coronal sequence was not obtained however no obvious evidence of alar ligament injury. Minimal fluid is noted involving the occipital condyle/C1 joint and atlantoaxial joint. No evidence of cord contusion or epidural hematoma. Ligamentous structures are intact. Vertebral body heights are normal. Alignment is normal. No significant spinal canal or neural foraminal stenosis is appreciated.
1. No evidence of intracranial hemorrhage. No findings to suggest diffuse axonal injury. 2. Fracture involving the anterior C1 arch better demonstrated on CT. No findings to suggest ligamentous injury. No abnormal signal in the cervical cord. No epidural hematoma.