Female, 63 years old, with intracerebral hemorrhage. Assess for resolution of hemorrhage and possible metastases. The previously demonstrated hematoma centered on the precuneus of the left posterior parietal lobe has evolved and now appears as an area of curvilinear hemosiderin staining. Mild residual T2 hyperintensity is seen in the adjacent corpus callosum.No new intracranial hemorrhage is demonstrated. Again seen is curvilinear hemosiderin staining along the right putamen compatible with chronic hemorrhage.Numerous scattered foci of T2 hyperintensity are demonstrated within the cerebral white matter. One lesion within the left centrum semiovale is new, but the lesions are otherwise not grossly changed.On postcontrast imaging, no evidence of any pathologic parenchymal or extra-axial enhancement is observed. In particular, no evidence of pathologic enhancement is seen in the vicinity of the prior hematoma. A developmental venous anomaly is seen in the right frontal lobe.No abnormal extra axial fluid collections are seen. The ventricles are normal in size and morphology.Opacification of the left maxillary sinus has significantly improved with only a small residual fluid level demonstrated. The right maxillary sinus, right ethmoid air cells and right frontal sinus remain completely opacified similar to prior with corresponding mucosal enhancement.
1.Expected evolution of the previously demonstrated left posterior parietal hematoma. The area now demonstrates only a thin layer of hemosiderin staining and mild residual signal abnormality in the adjacent corpus callosum.2.No enhancing lesions are identified to suggest the presence of metastatic disease.3.An area of chronic hemosiderin staining along the right putamen is unchanged. No new intracranial bleeding is seen.4.Extensive scattered white matter lesions are redemonstrated, most of which appear unchanged. However, one lesion in the left centrum semiovale is new. These findings may represent microvascular ischemia.5.Findings are seen compatible with active paranasal sinus inflammation with improvement in the left maxillary sinus.