Clinical question: Patient was transferred from an outside institution for respiratory failure. Found down at trauma on paralytics and sedated at outside hospital. Now lie attending sedation and off paralytic agents. Still minimally responsive. Non-enhanced CT of brain:There is lower than expected hypoattenuation of the white matter of bilateral cerebral hemispheres. There is however no evidence of effacement of cortical sulci, mass effect midline shift or hydrocephalus. The density of cortex and basal ganglia and thalami remain within normal limits. Considering provided clinical date of possibly two underlying diffuse cerebral edema cannot be entirely ruled out and follow-up with an MRI is recommended. It is also possible that this appearance may be technique related. Images through posterior fossa are essentially unremarkable.
Suspected cerebral edema of bihemispheric white matter as detailed. Considering patient's provided clinical date of follow-up with an MRI is recommended. There is no evidence of hemorrhage, mass-effect, midline shift or hydrocephalus. Please see above comments.