Female, 5 months old, ex full-term, with altered mental status, concern for seizure. Large bilateral subdural collections are seen along both cerebral hemispheres, most notably in the frontal and anterior temporal regions. Collections are fairly symmetric and measure up to 15 mm in thickness. The collections are T2 hyperintense, and on T1-weighted images are slightly hyperintense to CSF. Patchy areas of susceptibility effect are seen within the collections. There may also be trace T1 hyperintense subdural fluid along the bilateral occipital lobes and perhaps the cerebellum, but this fluid measures no more than 1 mm in thickness.The collections exert some degree of mass effect on the underlying brain with slight sulcal effacement. However, no herniation or midline shift is detected. Ventricular size and morphology are within normal limits. At most there may be minimal T2 hyperintense signal adjacent to the occipital horns, but this could be related to the normal terminal zones of myelination. No parenchymal edema is seen.No developmental or structural brain abnormalities are seen. The pattern of white matter myelination is appropriate for age. The pituitary region is unremarkable. The brainstem, cerebellar vermis and cerebellar hemispheres are normally formed. The corpus callosum is fully formed and intact.
Large bilateral subdural collections are seen which, given their signal characteristics and the presence of susceptibility effect, likely represent chronic hematomas. Trace T1 hyperintense fluid is also seen along the occipital lobes and the cerebellum which could potentially represent minimal subacute subdural blood product. The brain otherwise appears to be normally formed and intact. No parenchymal edema is seen. The ventricles are normal in size. Findings were discussed with Dr. Khan at 5:00 PM on 12/2/16.