Clinical question: Intracranial hemorrhage. Signs and symptoms: Altered mental status. Nonenhanced head CT:There is no detectable intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus.The cortical sulci, ventricular system, CSF cisterns and gray -- white differentiation remains within normal.Calvarium is intact. Paranasal sinuses and mastoid air cells are unremarkable. Limited views of the orbits demonstrate thickening of the extraocular musculature on the left and crowding of the retro-orbital space. There is also suspected increased density of the retro-orbital fat. Correlate weighted physical exam. Recommend enhanced MRI or dedicated CT of orbit with enhancement.
1.No evidence of intracranial abnormality.2.Apparent thickening of the extraocular musculature on the left side with crowding of the retro-orbital space and poor visualization of retro-orbital fat. Recommend dedicated MRI or CT of orbits.