Clinical question: Subarachnoid hemorrhage. Signs and symptoms: Same. Non-infused head CT:As was noted on multiple prior head CTs a large hematoma in the interhemispheric fissure with associated mass effect on lateral ventricles is again identified. The largest transverse axes measurement of hematoma is 29.9-mm which is similar to prior study.The lateral ventricles are shunted and remains stable in their normal size. No change in the position of the right-sided ventricular catheter with the tip in the right frontal horn of lateral ventricle.Examination demonstrates a well demarcated foci of low attenuation of cortex and subcortical white matter of right frontal and parietal lobes along its interhemispheric aspect consistent with ischemic strokes. These findings are best appreciated on axial image 30. The new area of ischemic stroke in the right frontal lobe measures approximately 11.4 x 19.2-mm and the right posterior parietal cortical stroke measures 13.4 x 25.8 mm. the stroke in the right parietal lobe extends inferiorly to involve the singlet gyrus.There is generalized paucity of cortical sulci in bilateral cerebral hemisphere and with suspected interval worsening suggestive of cerebral edema and possible additional nondetectable on this exam cortical strokes. MRI can further delineate the extent of cortical strokes.Residual blood in the subarachnoid space is again identified. There is no suggestion of any additional subarachnoid hemorrhage since prior study.
1.No evidence of new hemorrhage since prior study.2.Foci of ischemic cortical stroke in the right frontal and parietal lobes with no evidence of hemorrhage.3.Suspected further effacement of cortical sulci in bilateral cerebral hemispheres as detailed.4.The stable size of hematoma in the interhemispheric fissure since prior study.5.Stable size and right-sided ventricular catheter since prior exam.