Diagnosis: Abnormal involuntary movements(781.0)Clinical question: tremor, history of traumatic brain injurySigns and Symptoms: as above The patient is status post ventriculostomy tube placement which courses to the right frontal lobe into the right lateral ventricle and has its tip on the medial aspect of the right lateral ventricle.On susceptibility imaging there are multiple punctate foci of signal loss scattered throughout the subcortical white matter of the supratentorial brain. Punctate foci of hypointensity are also present in the brainstem and the cerebellar hemispheres. Some of these are associated with T2 and FLAIR signal hyperintensities.There is a small subdural effusion present. There is generalized brain atrophy present.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.
1.There are multiple microhemorrhages scattered throughout the brain predominantly in subcortical white matter and to lesser there are also present in the brainstem and cerebellar hemispheres.2.There is a mild degree of brain atrophy present.3.Status post ventriculostomy tube placement. The ventricles are rather large but to some degree this is probably related to atrophy.