 There is a left frontal and parietal hemispheric extra-axial fluid collection which has slightly hyperintense T1 signal with respect to CSF and T2/FLAIR hyperintense signal measuring up to 5 mm in maximal thickness on coronal T2 image 12. There is mild mass effect on the regional gyri and sulci but there is no significant midline shift or herniation. There is no acute infarct. There is no suspicious intracranial enhancement. The ventricles are unchanged with persistent dilatation of the fourth ventricle. There is moderate to severe global volume loss.There are unchanged remote postoperative signs related to suboccipital craniotomy with minimal T2 signal abnormality adjacent to the fourth ventricle. There are scattered foci of susceptibility effect in the right anterior temporal lobe, left parietal/temporal lobe, left cerebellar hemisphere, and at the postoperative site.There is moderate opacification of the bilateral mastoid air cells, new from prior exam. There are new small bilateral sphenoid sinus air fluid levels.
1.Thin left frontal and parietal hemispheric subacute subdural hematoma measuring up to 5 mm in maximal thickness with minimal localized mass-effect and no midline shift.2.No evidence of recurrent tumor.3.Nonspecific fluid opacification of mastoid air cells bilaterally as well as small air-fluid level in the right sphenoid sinus. Please correlate clinically.Findings were discussed with resident Dr. Warren Alperstein by Dr. Uppuluri over the telephone at 12:14 p.m. today.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.