 BRAIN: The endovascular coil adjacent to the right internal carotid communicating segment is not well seen. A right frontal ventriculostomy catheter is again present with its tip in the region of the foramen of the Monroe just past the midline. There is once again mild ventriculomegaly of the lateral and third ventricles, not significantly changed compared to 8/29/2015 CT. FLAIR and GRE signal abnormalities are again compatible with diffuse subarachnoid hemorrhage with intraventricular redistribution. Blooming artifact around the ventriculostomy catheter suggests a small amount of blood products around the catheter. Additional T1 and T2 hyperintense material within the anterior aspect of the sella turcica and within the prepontine cistern likely reflects additional blood products. There is no territorially restricted diffusion to suggest acute ischemic infarction. There is a single non-specific punctate focus of abnormal increased T2/FLAIR signal within the left periventricular white matter. There is no midline shift or herniation. The skull and scalp soft tissues are unremarkable. There is mild mucosal thickening within the ethmoid air cells. MRA HEAD: There is mild narrowing of the proximal intracranial arteries including the basilar artery, bilateral proximal ICAs, M1 segments of the middle cranial arteries, A1 segments of the anterior cerebral arteries, and P1 segments of the posterior cerebral arteries compatible with mild vasospasm. No recurrent right internal carotid communicating segment aneurysm is identified. No other aneurysms are identified. No high-grade stenosis is identified. There is a fetal origin of the posterior cerebral arteries bilaterally.
1.Postsurgical changes related to coiling of right internal carotid communicating segment aneurysm without evidence of recurrent aneurysm.2.Mild vasospasm of the proximal intracranial arteries.3.Stable mild ventriculomegaly with ventriculostomy catheter in place.4.Diffuse subarachnoid hemorrhage with intraventricular extension.