 MRI Brain:There is restricted diffusion involving the bilateral posterior putamina and likely restricted diffusion involving the bilateral upper caudate bodies compatible with hypoxic ischemic injury. Along the superior thalami there may be bilateral punctate areas of restricted diffusion as well. The cerebral cortex is relatively preserved and there is no evidence of edema in the brain parenchyma. There is a tiny burr hole within the right frontal bone and what appears to be a thin tract within the underlying brain parenchyma on T2/FLAIR images which could reflect prior instrumentation. A focus of restricted diffusion in this location adjacent to the burr hole mitral reflect postoperative artifact. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. There is mucosal thickening and fluid involving the bilateral maxillary sinuses and fluid in the sphenoid and ethmoid sinuses. There is also fluid in the bilateral mastoid air cells. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. MRI C-Spine:The craniovertebral junction appears within normal limits. The cervical spine alignment is maintained and the cervical vertebral bodies and disc spaces are appropriate in height. There is no evidence of STIR signal abnormality within the cervical spine bone marrow or ligaments. The cervical spinal cord has normal signal characteristics and overall morphology. There is no significant compromise to the spinal canal or neural foramina.
MRI Brain:1.Restricted diffusion within the bilateral basal ganglia, compatible with hypoxic ischemia. 2.Relative preservation of the cortical parenchyma without significant general edema.3.Mild signal changes within the right frontal lobe, consistent with prior instrumentation.MRI C-Spine:No cord signal abnormalities or imaging evidence of trauma involving the cervical spine osseous or ligamentous structures.