 There is a 1.1 x 0.9 cm ill-defined rounded non-enhancing lesion of T2 hyperintensity along the left cerebellar folia that has decreased in size and prominence. There is persistent but minimal mass effect along the gray white matter junction. There are additional nonspecific foci of subcortical T2 hyperintensity in the bilateral paramedian parietal regions at the convexity.There are findings related to an acute - early subacute large parenchymal hematoma within the left occipital lobe with surrounding vasogenic edema that results in unchanged mass effect on the local sulci, the left atrium and left occipital horn, as well as a 3-mm rightward midline shift. The size of the hematoma is unchanged, measuring 4.5 x 2.9 cm. There is no intraventricular hemorrhage and the ventricles are unchanged in size. There is thin enhancement along the left tentorium that likely represents reactive dural thickening, possibly due to trace subdural blood products seen in this area previously. There is essentially unchanged FLAIR signal hyperintensity throughout multiple frontal and parietal sulci bilaterally, right greater than left with minimal associated susceptibility effect, corresponding to areas of sulcal hyperattenuation on CT. There are unchanged additional scattered areas of sulcal FLAIR hyperintensity elsewhere without susceptibility effect which may relate to artifactual signal from sedation/oxygenation.There is no evidence of acute infarct. The major cerebral flow voids are intact. There is a moderate-sized air-fluid level within the right maxillary sinus. There is mucosal thickening within the sphenoid sinuses.
1.A rounded area of abnormal signal in the left cerebellum with mild mass effect appears smaller and less prominent on today's exam and does not enhance. The differential diagnosis primarily includes infectious/inflammatory etiologies such as a focal cerebellitis, demyelinating disease, and less likely ischemic etiologies. 2.Left occipital acute parenchymal hematoma is unchanged in size with unchanged mass effect and minimal midline shift.3.Mild grossly unchanged subarachnoid hemorrhage over the bilateral frontal and parietal lobes.4.Unchanged nonspecific subcortical FLAIR hyperintensity in the bilateral paramedian parietal lobes may represent additional subarachnoid hemorrhage or sedation artifact.5.Moderate sized air-fluid level within the right maxillary sinus. Please correlate clinically for acute sinusitis.