92 year-old female. Follow-up ICH. Intraparenchymal hemorrhage is present in the right frontal pole. Edema is present throughout the right cerebral hemisphere with effacement of the cortical sulci which is most pronounced in the frontal pole. Accounting for differences in technique, these findings appear grossly unchanged when compared to the MRI dated 4/21/2009.The hemorrhage associated edema exerts mass effect upon the right lateral ventricle. Approximately 6 mm of midline shift and subfalcine herniation is present at the level of the genu of the corpus callosum. The basal cisterns appear preserved.In addition to the parenchymal hemorrhage, subarachnoid blood is noted along the right frontotemporal region and in the left frontal convexity.Mucosal thickening and an air-fluid level (likely blood) are present in the left maxillary sinus. Scattered mucosal thickening is present in the ethmoid air cells. Scattered opacification is present in the mastoid air cells bilaterally.Fracture is present in the left posterolateral aspect of the maxilla (series 3 image 3). Bruising is noted in the soft tissues of the left facial region.
1. Right frontal lobe parenchymal hemorrhage with associated cerebral edema, mass effect, and midline shift. Accounting for differences in technique, these findings appears grossly unchanged from the MRI dated 4/21/2009.2. Maxillary fracture as detailed above. If this injury has not been previously evaluated, consider maxillofacial CT.3. Additional abnormalities as detailed above.