 There is a stable 16x10mm parenchymal hemorrhage within the left midbrain/thalamus with mild extension into the third ventricle. The hemorrhage involves the medial aspect of the left thalamus, the left quadrigeminal plate and the left periaqueductal gray. There is associated compression of the aqueduct of Sylvius. Biventricular diameter is identified on coronal imaging at the level of foramen of Monro is 50 mm on the current exam and unchanged since the 7/9/2015 exam. The third ventricle measures 12 mm in width and is unchanged. The temporal horns of the lateral ventricles appear similar to the prior exam.There are multiple hypodense foci present in the basal ganglia and centrum semiovale bilaterally right more than left. There is associated ex vacuo effect upon the right lateral ventricle. There are periventricular white matter hypodensities of a moderate to marked degree.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.There is opacification of the left maxillary sinus with air-fluid level. There is partial opacification of the left ethmoid sinus. The left mastoid air cell is partially opacified.
1.Stable CT of the head with no change in the focal hemorrhagic lesion centered in the left thalamus and quadrigeminal plate. There is mass effect associated with this. Underlying cause is not established on this exam2.Periventricular and subcortical white matter changes of a moderate to marked degree are nonspecific. At this age they are most likely vascular related. 3.There is redemonstration and no change in multiple old lacunar infarcts in the basal ganglia and centrum semiovale bilaterally.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.