Diagnosis: Traumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, sequelaClinical question: AMS with intraparenchymal bleed on Head CT, monitor for progression MRI of the brainThere is a hematoma centered in the right frontal lobe involving right middle and inferior frontal gyri. There is associated vasogenic pattern of edema.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate scattered opacities in the left anterior ethmoid air cells as well as left frontal sinus.. The visualized portions of the mastoid air cells demonstrate some scattered opacities. The visualized portions of the orbits are intact.Incidental note is made of partial empty sella.The cerebellar tonsils extend approximately 6 mm below the level of foramen magnum.MRA brain:Vasculature adjacent to the right frontal lobe hematoma is attenuated.Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.There is a hematoma centered in the right middle frontal gyrus. An underlying cause is not detected on this exam.2.No evidence for intracranial aneurysm.3.Findings are suspicious for Chiari I malformation.