Diagnosis: Nontraumatic subarachnoid hemorrhage, unspecifiedClinical question: SAH s/p EVD placement and removal, 3T Scanner pleaseSigns and Symptoms: 2 month follow up s/p SAH and EVD placement and removal MRI of the brainNo diffusion weighted abnormalities are appreciated.The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a focus of susceptibility effect present along the central portion of the midbrain and narrowing which measures approximately 14 x 4 mm axial dimensions on FLAIR imaging. It was in an acute stage on the 8/14/2015 MRI of the head. There is no new extension of this hematoma.A ventriculostomy tract courses through the right frontal lobe into the right lateral ventricle .There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are stable compared to the 8/14/2015 exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.Incidental note is made of dorsal origin of the left ophthalmic artery from the cavernous segment of the left internal carotid artery.The right v4 segment distal to the origin of the right PICA is hypoplastic.
1.No evidence for cerebrovascular occlusive disease.2.No evidence for intracranial aneurysm.3.There is a hemorrhagic focus present in the midbrain which was in an acute stage in August.4.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, or sarcoid. They are nonspecific. 