Clinical question: Patient with anoxic brain injury now with increasing seizure frequency. Evaluate for new bleed or focus of seizure. Nonenhanced CT of brain:There is prominence of cortical sulci and significant dilatation of ventricular system with interval worsening since prior study. Prominence of cortical sulci may indicate underlying parenchymal volume loss. Enlarged lateral ventricles and third ventricle are highly concerning for hydrocephalus. There is significant ballooning of the frontal horns bilaterally.There is also evidence of significant interval increase in extra-axial bilateral temporal, frontal and parietal CSF density subdural collections. Further follow-up with an MRI is recommended. There is no evidence of acute hemorrhage, edema or midline shift.
1. Interval increase in bilateral large CSF density subdural collections in temporal -- frontal and parietal regions and2.significant interval increase in the size of the supratentorial ventricular system concerning for hydrocephalus.3.No evidence of acute intracranial hemorrhage, edema or midline shift.4.Prominence of cortical sulci is concerning for underlying volume loss.