 Examination is significantly motion degraded. Again seen is intraparenchymal hemorrhage involving the right temporal lobe with surrounding vasogenic edema. There is restricted diffusion associated with blood products but without evidence of acute infarct surrounding this region. Small subdural hematoma along the bilateral cerebral convexities are noted including along the left anterior frontal region as seen on recent CT. There are additional extra-axial collections along the bilateral cerebral convexities measuring up to 11 mm on the left and 5 mm on the right with predominant CSF signal features; there is mildly increased FLAIR hyperintensity within these bilateral subdural collections although some of this may be artifactual related to motion. Minimal scattered subarachnoid blood products are better appreciated on recent CT given the significant motion degradation on the current MRI.There are scattered foci of T2/FLAIR hyperintensity in the periventricular and subcortical white matter which are nonspecific but compatible with mild chronic small vessel ischemic changes. No obvious underlying mass is evident in the limitations of noncontrast MRI. No significant midline shift, herniation, or hydrocephalus. Global parenchymal volume loss is evident.MRA HEAD
1. Examination is significantly motion degraded. Again seen is intraparenchymal hematoma in the right temporal lobe with surrounding edema. There are also bilateral acute subdural hematomas which appear superimposed on underlying bilateral chronic subdural hematomas/hygromas. Additional scattered subarachnoid blood products are also again seen. No underlying infarct or intracranial masses are evident. Given the motion degradation and lack of contrast, follow-up MR imaging may be considered as clinically appropriate.2. No findings to suggest an arteriovenous malformation. MR venogram demonstrates a nondominant right-sided venous system with some flow in the right sigmoid sinus and proximal internal jugular vein. Patency of the right transverse sinus and vein of Labbe cannot be confirmed on this study. If repeat examination with sedation cannot be obtained, CTV may be considered as clinically indicated. 