Clinical question: Hepatic encephalopathy, now with acute mental status change, only responsive to pain. Signs and symptoms: Altered mental status. Very minimal blood adjacent to right frontal pressure monitor is again identified with no interval change. No evidence of hemorrhage, edema, mass-effect, midline shift or hydrocephalus since prior study. No definitive evidence of edema or parenchymal air is detected. Cortical sulci, ventricular system and all CSF cisterns are stable since prior study. Extensive opacification of all paranasal sinuses with interval worsening since prior exam. The above findings could be related to instrumentation.Further evaluation with an MRI is recommended.
No definitive evidence of any new finding since prior exam. Please see above comments.