75 years, Male, status post motor vehicle accident and subarachnoid hemorrhage one month ago. Slow recovery with lingering cognitive deficits and impaired short-term, verbal memory. There are multiple foci of susceptibility effect involving scattered sulci in the bilateral cerebral hemispheres consistent with prior subarachnoid hemorrhage. Blood products are relatively more prominent in the posterior frontal and bilateral parietal regions. Linear foci of susceptibility along the anterior body of the corpus callosum on the right are also noted which may be related to prior shear/diffuse axonal injury, a thrombosed vessel seems less likely. Parenchymal foci of petechial hemorrhage are also noted in the right parietal lobe white matter with corresponding T2/FLAIR hyperintensity.No intracranial mass or mass-effect. There is global parenchymal volume loss commensurate with patient's age. No hydrocephalus. No extra-axial collections. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with minimal chronic small vessel ischemic changes. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. There is minimal scattered paranasal sinus mucosal thickening. Calvarium and extracranial soft tissues appear grossly unremarkable.
Multiple foci of susceptibility effect related to chronic blood products, primarily involving the sulci along the frontoparietal convexities, are consistent with history of prior traumatic subarachnoid hemorrhage. There is also evidence of minimal chronic parenchymal hemorrhage. Linear foci of parenchymal hemorrhage are seen along the right corpus callosum, which can be a sign of diffuse axonal injury.