Weakness. Evaluate for ischemia/infarction. Similar to the same day head CT, there is evidence of a large hematoma within the right cerebellar hemisphere with intraventricular hemorrhagic extension. Again seen is subdural hemorrhage along the right tentorium. There is upward transtentorial herniation of the brainstem and medial cerebellar contents along as well as extensive restricted diffusion involving the brainstem, cerebellar peduncles and cerebellum bilaterally compatible with extensive ischemic infarct. Again seen are postsurgical changes of a suboccipital craniectomy for posterior fossa decompression as well as a right frontal approach ventriculostomy catheter which terminates in the right foramen of Monro similar in position to the previous head CT. There has been interval reduction in the right ventricular dilatation. However the left lateral ventricle, including the left temporal horn, has slightly enlarged compared to the previous CT indicating possible left lateral ventricular entrapment.
1.Postsurgical changes of a suboccipital craniectomy for posterior fossa decompression of a large right cerebellar hemisphere hematoma with intraventricular extension and right tentorial subdural hemorrhage.2.Persistent upper transtentorial herniation3.Restricted diffusion involving the brainstem, cerebellar peduncles and cerebellar hemispheres bilaterally indicating acute ischemic infarct.4.Unchanged position of the right frontal approach ventriculostomy catheter with reduction in size of the right lateral ventricles. However the left lateral ventricle has become more somewhat more dilated compared to the previous head CT including the left temporal horn suspicious for possible ventricular entrapment.