 MRI brain: There are significant susceptibility artifacts arising from the ventriculostomy reservoir. There are bihemispheric subdural fluid collections in the frontoparietal convexities which demonstrates fluid signal intensity containing internal susceptibility artifacts consistent with chronic subdural hematoma. The extension of the subdural collection with bilateral temporo-occipital area and subtentorial T1 and T2 hyperintense lesions indicate subacute subdural hematoma do not show any interval change since prior scan. Gyriform high signal intensities on T1 weighted images on bilateral frontal lobes indicate laminar necrosis related to prior ischemic insults.There is a left frontal approach ventriculostomy catheter with tip terminating in the region of right thalamus, unchanged from previous exam. There is effacement of the right lateral ventricle which is unchanged from previous exam. There is no midline shift or herniation.Incidentally noted is partially empty sella, a normal variant. Please note that this study was not tailored for pituitary evaluation.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is opacification of bilateral maxillary sinuses, left frontal sinuses including mild opacification of the ethmoid sinuses. There are partial opacifications of bilateral mastoid air cells.MRI cervical spine:There is loss of normal cervical lordosis. There is degenerative changes involving multiple cervical vertebrae, including loss of intervertebral disc height at C6-C7. No focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There are diffuse disc bulge and mild central osteophyte disc complex resulting in mild effacement of the anterior thecal sac. There is mild spinal canal stenosis. There is no significant neuroforaminal narrowing.C4-5: There is mild disc bulge. There is mild to moderate spinal canal stenosis. There is minimal bilateral neuroforaminal narrowing.C5-6: There is diffuse disc bulge. There is minimal spinal canal stenosis. No significant compromise to the neural foramina.C6-7:No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.
1. Bihemispheric multi-stage subdural hematoma including bilateral temporo-occipital subacute SDH as described above.2. Left frontal approach ventriculostomy catheter, is unchanged from previous.3. Effacement of the right lateral ventricle, unchanged from previous.4. Partially empty sella, a normal variant. Please note that this study is not tailored for pituitary evaluation. Dedicated pituitary MRI can be considered if clinically indicated.5. Opacification of the paranasal sinuses and mastoid air cells.6. Degenerative changes in the cervical spine with mild to moderate spinal canal stenosis at C4-C5. There are mild spinal canal stenosis at C3-C4, and C5-C6 levels. Mild neural foraminal narrowing is noted at C4-C5.