76 year-old and status-post fall Multiple small parenchymal hematomas in the right frontal lobe in the mid to high convexity are noted. The largest hematoma measures 8.8-mm x 14.6-mm measured on axial image 17. Minimal surrounding vasogenic edema is noted. Minimal amount of blood in the subarachnoid space in the right and left frontal region is also noted.Hematoma within the medial aspect of left temporal lobe at the level of the edge of the tentorium measures 30-mm times 18-mm in transaxial dimension on axial image 12. There is evidence of extension of blood into the trigone of left lateral ventricle. Minimal amount of blood within the perimesencephalic cistern is also noted. A small area of contusion with surrounding vasogenic edema within the inferior aspect of the right frontal lobe at the level of the floor of the right anterior cranial fossa is also present.Extensive patchy areas of low attenuation in the periventricular white matter of both cerebral hemispheres is consistent with small vessel disease.Large area of CSF collection in the right middle cranial fossa is contiguous with trigone of the right lateral ventricle and is believed to represent ex vacuo dilation of the right temporal horn. This area can be better evaluated with an MRI exam. No hydrocephalus or midline shift.No evidence of abnormality of the paranasal sinuses or mastoid air cells. Calvarium remains essentially unremarkable. Soft tissue density containing multiple foci of increased density within the high convexity right frontal scalp is noted. This lesion measures 15.5-mm x 18 0.2-mm. there is no evidence of associated bony changes with this finding and soft tissues of the scalp adjacent to these lesion demonstrate no evidence of edematous changes. The exact etiology of this finding is not clear however the finding less likely to represent a hematoma and possibly could represent a sebaceous cyst or a soft tissue mass of the scalp.
1.Multiple areas of hemorrhagic contusion of the brain in both cerebral hemispheres as detailed.2.Extension of blood from the left middle temporal lobe hematoma into the trigone of left lateral ventricle.3.Significant ex vacuo dilation of right temporal horn of uncertain etiology. This finding can be further monitored with a dedicated MRI.4.Small vessel disease of indeterminate age.5.Notice of fracture.6.Well pneumatized mastoid air cells and paranasal sinuses.