 During the study, the patient became agitated and did not wish to continue. Best attempts were made at obtaining diagnostic images.Redemonstrated are bilateral partially calcified subdural hematomas (right larger than left), which due to their calcific component are better demonstrated on prior head CT. As before, there is significant associated regional right hemispheric mass effect causing approximately 8 mm right to left midline shift, although this is stable in appearance. There is confluent white matter T2 hyperintensity, primarily in a periventricular distribution, without associated restricted diffusion or mass effect, matching the diffuse hypodensity noted on the prior head CT. As before, a ventriculostomy catheter is noted entering via a left frontal approach with its tip near the leftward foramen of Monroe, unchanged in position. A second ventriculostomy catheter is again noted via a right parietal approach, with its tip in the left frontal horn, unchanged in position. A focus of susceptibility hypointensity at the tip of this second catheter is consistent with the previous small focus of hemorrhage at the catheter tip identified on prior head CT. Ventricular sizes are stable. Intraventricular air has resolved. Susceptibility hypointensity along the shunt is consistent with hemorrhagic products as noted on the prior head CT. Smooth dural enhancement with minimal thickening is noted adjacent to the subdural collections. There is no abnormal parenchymal enhancement. There is a prominent CSF collection extending from the suprasellar region to the pineal region causing flattening of the tectal plate, better demonstrated by multiplanar MRI, which has not significantly changed. Diffuse calvarial thickening is again noted. Expected vascular flow voids are demonstrated. The cerebellar tonsils are in an appropriate position. The pituitary is unremarkable in appearance.
1.Redemonstrated are bilateral partially calcified subdural hematomas (right larger than left), with significant associated regional right hemispheric mass effect causing approximately 8 mm right to left midline shift which is stable in appearance. 2.There is confluent white matter T2 hyperintensity, primarily in a periventricular distribution, without associated restricted diffusion or mass effect, matching the diffuse hypodensity noted on the prior head CT.3.Unchanged left frontal and right parietal ventriculostomy catheters.4.Stable ventricular sizes.5.There is no abnormal parenchymal enhancement. 6.There is a prominent CSF collection extending from the suprasellar region to the pineal region causing flattening of the tectal plate, better demonstrated by multiplanar MRI, which has not significantly changed.