Clinical question: Evaluate for hemorrhage. Signs and symptoms: New aphasia Non-infused CT of brain:Postoperative changes of an old left craniotomy in the frontal and temporal region. Focal areas of encephalomalacia in the left frontal, temporal and left caudate nucleus are again identified. There is ex vacuo dilatation of left frontal horn.Expected postoperative changes of a large right-sided frontal -- temporal craniotomy which extends across the midline. There is no evidence of parenchymal hemorrhage no definitive evidence of an ischemic process. Aneurysm clips bilaterally adjacent to the sella from prior surgeries produce significant artifact and obscures the detail in the peri-surgical site. Further follow-up with an MRI is recommended considering provided clinical data. The ventricular system are within normal size and no midline shift.No definitive detectable acute intracranial finding.
1.No definitive new acute intracranial findings.2.Expected postoperative changes of a larger right frontal and temporal craniotomy.3.Old left frontal and temporal craniectomy with underlying foci of encephalomalacia in the right temporal, right frontal and right caudate nucleus.