Right upper extremity weakness. The imaged are degraded by patient motion. There is high T2 signal and mild swelling of the left medial temporal lobe and basal ganglia without restricted diffusion. There are otherwise multiple scattered areas of cerebral and pontine white matter T2 hyperintensity. There are bilateral cerebral convexity subdural effusions, which measures up to 4 mm in thickness. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Sequelae of maxillofacial trauma are better delineated on the prior CTs.
1. High T2 signal and mild swelling of the left medial temporal lobe and basal ganglia without restricted diffusion may represent traumatic brain injury, subacute infarction superimposed upon a background of chronic small vessel ischemic disease, and less likely neoplasm, although the assessment is limited by patient motion and the lack of intravenous contrast. Otherwise, no evidence of acute infarction. Nevertheless, follow up with a brain MRI with contrast is recommended.2. Small bilateral cerebral convexity subdural hygromas.3. Sequelae of maxillofacial trauma are better delineated on the prior CTs.