Clinical question: Intracranial hemorrhage, fracture. Signs and symptoms: Head trauma. Nonenhanced CT brain:Diffuse area of encephalomalacia in the left frontal, temporal, parietal lobes with ex vacuo dilatation of the left lateral ventricle is consistent with an old stroke. This examination is otherwise unremarkable and in particular no evidence of acute intracranial process is detected.There is a slight widening of calvarium on the left side believed to be secondary to underlying parenchymal volume loss. Area of sclerotic change of the squamosal portion of left temporal bone may also be result of intracranial process however possibility of fibrous dysplasia should be considered. Visualized paranasal sinuses and mastoid air cells are unremarkable. There is no definitive abnormality of soft tissues of the scalp.Nonenhanced CT of cervical spine:The alignment of cervical spine remains within normal limits.There is no definitive evidence of fracture or malalignment. Advanced degenerative disk disease with large anteriorly projecting osteophytes at C3 -- C4 through C6 -- C7 levels are present. At C5 -- C6 within the anteriorly projecting osteophytes and lucent line is identified. Remote possibility of fracture of this osteophyte cannot be ruled out. There is no detectable soft tissue abnormality associated with this finding. Correlated with physical exam and direct palpation and if clinical concern persists a follow-up with an MRI is recommended.
1.No evidence of acute intracranial or calvarial pathology.2.Large area of encephalomalacia in the left frontal, temporal and parietal lobes with resultant ex vacuo dilation of left lateral ventricle.3.Calvarial changes secondary to significant left hemispheric parenchymal volume loss is evident by thickening of calvarium on the left. Focal area of fibrous dysplasia of the squamosal portion of the left temporal bone.4.No definitive evidence of fracture of the cervical spine. Lucent line traversing the anterior osteophyte at C5 -- C6 likely not a fracture. Please correlate with history and if clinical concern persists follow-up with an MRI is recommended.